Healthcare Provider Details

I. General information

NPI: 1194805705
Provider Name (Legal Business Name): LINDELL PHYSICAL THERAPY OF DELAWARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CONCORD PIKE STE 4
WILMINGTON DE
19803-5038
US

IV. Provider business mailing address

3300 CONCORD PIKE STE 4
WILMINGTON DE
19803-5038
US

V. Phone/Fax

Practice location:
  • Phone: 302-753-2700
  • Fax: 302-478-1975
Mailing address:
  • Phone: 302-753-2700
  • Fax: 302-478-1975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JAY STUART KOGON
Title or Position: OWNER/PRESIDENT
Credential: P.T.
Phone: 302-998-7572