Healthcare Provider Details

I. General information

NPI: 1588382535
Provider Name (Legal Business Name): UD HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DISCOVERY BLVD STE 211
NEWARK DE
19713-1325
US

IV. Provider business mailing address

100 DISCOVERY BLVD STE 211
NEWARK DE
19713-1325
US

V. Phone/Fax

Practice location:
  • Phone: 302-831-1165
  • Fax: 302-309-9163
Mailing address:
  • Phone: 302-831-1165
  • Fax: 302-309-9163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: JED CASTELLUCCI
Title or Position: CHIEF CLINICAL OPERATING OFFICER
Credential:
Phone: 302-831-2705