Healthcare Provider Details

I. General information

NPI: 1285992347
Provider Name (Legal Business Name): AMY CHRISTINE CHASE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD CHRISTIANA HOSPITAL SUITE 2A00
NEWARK DE
19718-0001
US

IV. Provider business mailing address

29 MARATHON DR
SEAFORD DE
19973-9358
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1042
  • Fax: 302-733-1068
Mailing address:
  • Phone: 443-235-3281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: