Healthcare Provider Details

I. General information

NPI: 1821077462
Provider Name (Legal Business Name): VINCENT D ABBRESCIA D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING STREET SUITE 340
DOVER DE
19904
US

IV. Provider business mailing address

640 S. STATE STREET MAIL CODE 3055
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-734-1414
  • Fax: 302-734-2121
Mailing address:
  • Phone: 302-480-1688
  • Fax: 302-480-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC2-0006879
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: