Healthcare Provider Details

I. General information

NPI: 1548171044
Provider Name (Legal Business Name): EMILY ELIZABETH TESTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S MAIN ST STE 104
SMYRNA DE
19977-1478
US

IV. Provider business mailing address

31 SLASHPINE CIR
HOCKESSIN DE
19707-9206
US

V. Phone/Fax

Practice location:
  • Phone: 302-486-0176
  • Fax:
Mailing address:
  • Phone: 302-584-2389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0012520
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: