Healthcare Provider Details
I. General information
NPI: 1932389020
Provider Name (Legal Business Name): ADA MONET CUNNINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/06/2007
Last Update Date: 06/09/2024
Certification Date: 06/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19 LAMBSON LN STE A104-2
NEW CASTLE DE
19720-2118
US
IV. Provider business mailing address
19 LAMBSON LN STE A104-2
NEW CASTLE DE
19720-2118
US
V. Phone/Fax
- Phone: 302-544-2333
- Fax: 302-351-7228
- Phone: 302-544-2333
- Fax: 302-351-7228
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246RM2200X |
| Taxonomy | Medical Laboratory Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: