Healthcare Provider Details

I. General information

NPI: 1972332799
Provider Name (Legal Business Name): RAFIQUENDOCRINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 PRIDES XING STE 306
NEWARK DE
19713-6109
US

IV. Provider business mailing address

321 DILLON CIR
MIDDLETOWN DE
19709-8365
US

V. Phone/Fax

Practice location:
  • Phone: 302-240-6886
  • Fax:
Mailing address:
  • Phone: 610-422-1731
  • Fax:

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: RAAFIA MEMON
Title or Position: OWNER
Credential: MD
Phone: 610-422-1731