Healthcare Provider Details

I. General information

NPI: 1578714648
Provider Name (Legal Business Name): LEFTERIA D MEALY P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 POWDER MILL RD PO BOX
WILMINGTON DE
19803-2907
US

IV. Provider business mailing address

200 POWDER MILL RD PO BOX
WILMINGTON DE
19803-2907
US

V. Phone/Fax

Practice location:
  • Phone: 302-695-2437
  • Fax: 302-695-1364
Mailing address:
  • Phone: 302-695-2437
  • Fax: 302-695-1364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: