Healthcare Provider Details

I. General information

NPI: 1841753464
Provider Name (Legal Business Name): NEELAM KUMARI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 OGLETOWN STANTON RD STE 1250
NEWARK DE
19713-2076
US

IV. Provider business mailing address

4735 OGLETOWN STANTON RD STE 1250
NEWARK DE
19713-2076
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-0200
  • Fax: 302-623-0117
Mailing address:
  • Phone: 302-623-0200
  • Fax: 302-623-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC2-0024039
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: