Healthcare Provider Details
I. General information
NPI: 1588359178
Provider Name (Legal Business Name): HUNTER C KUPCHELLA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/10/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 ROCKLAND RD STE 3D16
WILMINGTON DE
19803-3607
US
IV. Provider business mailing address
1600 ROCKLAND RD STE 3D16
WILMINGTON DE
19803-3607
US
V. Phone/Fax
- Phone: 302-651-5874
- Fax: 302-651-5954
- Phone: 302-651-5874
- Fax: 302-651-5954
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | OT022621 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: