Healthcare Provider Details

I. General information

NPI: 1891750246
Provider Name (Legal Business Name): JUDITH N FEICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 09/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 SKYLINE DR SUITE # 4
WILMINGTON DE
19808-1772
US

IV. Provider business mailing address

PO BOX 191
ROCKLAND DE
19732-0191
US

V. Phone/Fax

Practice location:
  • Phone: 302-239-7755
  • Fax: 302-234-2735
Mailing address:
  • Phone: 302-651-6212
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC10003251
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: