Healthcare Provider Details

I. General information

NPI: 1497506968
Provider Name (Legal Business Name): UNION HOSPITAL OF CECIL COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W HIGH ST STE 302
ELKTON MD
21921-8617
US

IV. Provider business mailing address

4000 NEXUS DR # E3
WILMINGTON DE
19803-3000
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-6154
  • Fax:
Mailing address:
  • Phone: 302-428-6782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JUDY RIESEN
Title or Position: CORPORATE DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 302-623-7168