Healthcare Provider Details

I. General information

NPI: 1619529559
Provider Name (Legal Business Name): ROSEMARIE CARDIE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSEMARIE MCLAUGHLIN PA-C

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W. 14TH ST.
WILLMINGTON DE
19801
US

IV. Provider business mailing address

621 AUTUMN LANE
MEDIA PA
19063
US

V. Phone/Fax

Practice location:
  • Phone: 302-320-9441
  • Fax:
Mailing address:
  • Phone: 610-739-7236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0001320
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: