Healthcare Provider Details

I. General information

NPI: 1457284002
Provider Name (Legal Business Name): FIRST STATE ORTHOPAEDICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17015 OLD ORCHARD RD UNIT 1
LEWES DE
19958-4849
US

IV. Provider business mailing address

211 EXECUTIVE DR STE 11
NEWARK DE
19702-3358
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-3311
  • Fax: 302-644-3300
Mailing address:
  • Phone: 302-731-2888
  • Fax: 302-644-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN R MURPHY
Title or Position: CREDENTIALING
Credential:
Phone: 302-644-3311