Healthcare Provider Details

I. General information

NPI: 1205384849
Provider Name (Legal Business Name): GERIATRIC MEDICINE CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 FOXHUNT DR
BEAR DE
19701-2536
US

IV. Provider business mailing address

1601 MILLTOWN RD SUITE 2
WILMINGTON DE
19808-4027
US

V. Phone/Fax

Practice location:
  • Phone: 302-918-7680
  • Fax:
Mailing address:
  • Phone: 302-543-6165
  • Fax: 302-543-6130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLG-0000962
License Number StateDE

VIII. Authorized Official

Name: DR. RITU RASTOGI
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 302-543-6165