Healthcare Provider Details

I. General information

NPI: 1629187646
Provider Name (Legal Business Name): PSYCHIATRIC ACCESS FOR CENTRAL DELAWARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 WALKER RD STE. 32-2
DOVER DE
19904-2756
US

IV. Provider business mailing address

846 WALKER RD STE. 32-2
DOVER DE
19904-2756
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-2265
  • Fax: 302-674-3321
Mailing address:
  • Phone: 302-674-2265
  • Fax: 302-674-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number1989031835
License Number StateDE

VIII. Authorized Official

Name: DR. MARK S. BORER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 302-674-2265