Healthcare Provider Details

I. General information

NPI: 1548099260
Provider Name (Legal Business Name): ALEXA MCSORLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 STANTON CHRISTIANA RD
NEWARK DE
19713-2146
US

IV. Provider business mailing address

537 STANTON CHRISTIANA RD
NEWARK DE
19713-2146
US

V. Phone/Fax

Practice location:
  • Phone: 302-633-7550
  • Fax:
Mailing address:
  • Phone: 302-633-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0012087
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: