Healthcare Provider Details

I. General information

NPI: 1144308412
Provider Name (Legal Business Name): CENTRAL DELAWARE FAMILY FOOT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 S GOVERNORS AVE SUITE B
DOVER DE
19904-4800
US

IV. Provider business mailing address

1326 S GOVERNORS AVE SUITE B
DOVER DE
19904-4800
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-3338
  • Fax: 302-678-5538
Mailing address:
  • Phone: 302-678-3338
  • Fax: 302-678-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT J GEMIGNANI
Title or Position: OWNER
Credential: DPM
Phone: 302-678-3338