Healthcare Provider Details

I. General information

NPI: 1700864576
Provider Name (Legal Business Name): NEWARK EMERGENCY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 E MAIN ST
NEWARK DE
19711
US

IV. Provider business mailing address

PO BOX 3012
WILMINGTON DE
19804
US

V. Phone/Fax

Practice location:
  • Phone: 302-738-4300
  • Fax:
Mailing address:
  • Phone: 800-456-4629
  • Fax: 302-224-2848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMIR MANSOORY
Title or Position: PRESIDENT
Credential: MD
Phone: 800-456-4629