Healthcare Provider Details

I. General information

NPI: 1801705744
Provider Name (Legal Business Name): AFFIRM SPECIALTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 CHARLESTON CIR
DOVER DE
19904-4990
US

IV. Provider business mailing address

107 CHARLESTON CIR
DOVER DE
19904-4990
US

V. Phone/Fax

Practice location:
  • Phone: 302-983-4244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH OBASANYA
Title or Position: OWNER / AUTHORIZED OFFICIAL
Credential:
Phone: 302-983-4244