Healthcare Provider Details

I. General information

NPI: 1528224615
Provider Name (Legal Business Name): JUAN GADEA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 02/22/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 W CHESTNUT HILL RD STE 6
NEWARK DE
19713-2210
US

IV. Provider business mailing address

179 W CHESTNUT HILL RD STE 6
NEWARK DE
19713-2210
US

V. Phone/Fax

Practice location:
  • Phone: 302-731-5713
  • Fax:
Mailing address:
  • Phone: 302-731-5713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC1-0T00212
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: