Healthcare Provider Details

I. General information

NPI: 1851338297
Provider Name (Legal Business Name): FIRST STATE WOMEN'S CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 OGLETOWN STANTON RD SUITE 106
NEWARK DE
19713-2067
US

IV. Provider business mailing address

4735 OGLETOWN STANTON RD SUITE 1109
NEWARK DE
19713-2072
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-9800
  • Fax: 302-454-6446
Mailing address:
  • Phone: 302-454-9800
  • Fax: 302-454-6446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: LYNNE M GRAJEWSKI
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 302-454-9800