Healthcare Provider Details

I. General information

NPI: 1649973132
Provider Name (Legal Business Name): ALEXA VECCHIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BECKS WOODS DR STE 100
BEAR DE
19701-3853
US

IV. Provider business mailing address

1218 LAKE SEYMOUR DR
MIDDLETOWN DE
19709-4674
US

V. Phone/Fax

Practice location:
  • Phone: 302-261-5600
  • Fax:
Mailing address:
  • Phone: 201-452-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0012171
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: