Healthcare Provider Details

I. General information

NPI: 1871431551
Provider Name (Legal Business Name): TIKARI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PENNINGTON ST STE 100
MIDDLETOWN DE
19709-1026
US

IV. Provider business mailing address

12 PENNINGTON ST STE 100
MIDDLETOWN DE
19709-1026
US

V. Phone/Fax

Practice location:
  • Phone: 302-203-7113
  • Fax:
Mailing address:
  • Phone: 302-203-7113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JERISE ATOCK AGHA
Title or Position: PROVIDER
Credential: NURSE PRACTITIONER
Phone: 302-130-2203