Healthcare Provider Details

I. General information

NPI: 1285783811
Provider Name (Legal Business Name): JAMES M PORCELLI DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CLEAVER FARMS RD STE 1
MIDDLETOWN DE
19709-1670
US

IV. Provider business mailing address

1050 INDUSTRIAL DR STE 210
MIDDLETOWN DE
19709-2803
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-2048
  • Fax: 302-449-2047
Mailing address:
  • Phone: 302-449-2048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21766
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: