Healthcare Provider Details

I. General information

NPI: 1477346872
Provider Name (Legal Business Name): MADELINE ASHLEY KUCHTA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH DE
19971-4480
US

IV. Provider business mailing address

1515 SAVANNAH RD
LEWES DE
19958-1675
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3770
  • Fax: 302-645-5718
Mailing address:
  • Phone: 302-645-3499
  • Fax: 302-644-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: