Healthcare Provider Details

I. General information

NPI: 1508652447
Provider Name (Legal Business Name): SKYLER DELLA FAVE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRANDYWINE BLVD
TALLEYVILLE DE
19803-1838
US

IV. Provider business mailing address

832 MONTICO RD
WILMINGTON DE
19803-4007
US

V. Phone/Fax

Practice location:
  • Phone: 302-703-7779
  • Fax:
Mailing address:
  • Phone: 201-841-4331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberL8-0010824
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: