Healthcare Provider Details
I. General information
NPI: 1639032667
Provider Name (Legal Business Name): FYZICAL DELAWARE NORTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 SILVERSIDE RD STE B
WILMINGTON DE
19810-5100
US
IV. Provider business mailing address
3600 SILVERSIDE RD STE B
WILMINGTON DE
19810-5100
US
V. Phone/Fax
- Phone: 302-212-4778
- Fax: 302-203-9966
- Phone: 302-212-4778
- Fax: 302-203-9966
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
GILBERT
Title or Position: OWNER
Credential:
Phone: 302-212-4778