Healthcare Provider Details

I. General information

NPI: 1245563964
Provider Name (Legal Business Name): MADELINE DONATO BURGOS APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 OGLETOWN STANTON RD STE 2335 HELEN F. GRAHAM CANCER CENTER WEST
NEWARK DE
19713-7016
US

IV. Provider business mailing address

200 HYGEIA DR SUITE 2300
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-4285
  • Fax: 302-623-4155
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN-0001550
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLH-0000191
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: