Healthcare Provider Details

I. General information

NPI: 1205871910
Provider Name (Legal Business Name): DIAGNOSTIC ENDEAVORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 CHRISTIANA RD SUITE 202
NEWARK DE
19713-4236
US

IV. Provider business mailing address

774 CHRISTIANA RD SUITE 202
NEWARK DE
19713-4236
US

V. Phone/Fax

Practice location:
  • Phone: 302-366-7671
  • Fax: 302-366-7655
Mailing address:
  • Phone: 302-366-7671
  • Fax: 302-366-7655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2005200819
License Number StateDE

VIII. Authorized Official

Name: DR. YAKOV U KOYFMAN
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 302-366-7671