Healthcare Provider Details

I. General information

NPI: 1295009660
Provider Name (Legal Business Name): FIRST STATE ENDOCRINOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 CHRISTIANA RD STE 109
NEWARK DE
19713-4248
US

IV. Provider business mailing address

774 CHRISTIANA RD STE 109
NEWARK DE
19713-4248
US

V. Phone/Fax

Practice location:
  • Phone: 302-444-8156
  • Fax: 302-731-8158
Mailing address:
  • Phone: 302-444-8156
  • Fax: 302-731-8158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: RIPUDAMAN S HUNDAL
Title or Position: PHYSICIAN
Credential: MD
Phone: 302-451-5610