Healthcare Provider Details

I. General information

NPI: 1780124834
Provider Name (Legal Business Name): SHAINA CICHANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 W 6TH ST
WILMINGTON DE
19805-1828
US

IV. Provider business mailing address

502 BRIDLE DR
WILMINGTON DE
19810-2262
US

V. Phone/Fax

Practice location:
  • Phone: 302-655-6135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: