Healthcare Provider Details

I. General information

NPI: 1841234564
Provider Name (Legal Business Name): CARDIOLOGY CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 CHAPMAN RD SUITE 150
NEWARK DE
19702-5438
US

IV. Provider business mailing address

252 CHAPMAN RD SUITE 150
NEWARK DE
19702-5438
US

V. Phone/Fax

Practice location:
  • Phone: 302-366-7665
  • Fax: 302-366-0734
Mailing address:
  • Phone: 302-366-7665
  • Fax: 302-366-0734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY GEORGE
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 302-366-7665