Healthcare Provider Details

I. General information

NPI: 1720078504
Provider Name (Legal Business Name): JANE A IERARDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANE RUBATZKY

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND RD
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

PO BOX 191
ROCKLAND DE
19732-0191
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4200
  • Fax: 302-651-4945
Mailing address:
  • Phone:
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME131969
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number25MA06045400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: