Healthcare Provider Details

I. General information

NPI: 1487579256
Provider Name (Legal Business Name): NEPHROLOGY ASSOCIATES PA ASC OF MILFORD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W LIBERTY WAY
MILFORD DE
19963-5399
US

IV. Provider business mailing address

201 W LIBERTY WAY
MILFORD DE
19963-5399
US

V. Phone/Fax

Practice location:
  • Phone: 302-424-3694
  • Fax:
Mailing address:
  • Phone: 302-424-3694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GINA JOHNSTON
Title or Position: EXECUTIVE
Credential:
Phone: 302-225-0451