Healthcare Provider Details

I. General information

NPI: 1104854850
Provider Name (Legal Business Name): CHRISTIANA INSTITUTE OF ADVANCED SURGERY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 STANTON CHRISTIANA ROAD STE 102
NEWARK DE
19713-2145
US

IV. Provider business mailing address

537 STANTON CHRISTIANA ROAD STE 102
NEWARK DE
19713-2145
US

V. Phone/Fax

Practice location:
  • Phone: 302-892-9900
  • Fax: 302-892-9980
Mailing address:
  • Phone: 302-892-9900
  • Fax: 302-892-9980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ISAIAS IRGAU
Title or Position: PRACTICE OWNER
Credential: MD
Phone: 302-892-9900