Healthcare Provider Details

I. General information

NPI: 1427306240
Provider Name (Legal Business Name): DELAWARE VASCULAR AND VEIN CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 CHRISTIANA RD SUITE 109
NEWARK DE
19713-4236
US

IV. Provider business mailing address

774 CHRISTIANA RD SUITE 109
NEWARK DE
19713-4236
US

V. Phone/Fax

Practice location:
  • Phone: 302-533-5103
  • Fax: 302-533-5175
Mailing address:
  • Phone: 302-533-5103
  • Fax: 302-533-5175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberC10006224
License Number StateDE

VIII. Authorized Official

Name: SONYA NATALIE TUERFF
Title or Position: VASCULAR SURGEON
Credential: M.D.
Phone: 302-533-5103