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General NPI Number Information
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NPI Number | 1053152652
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Entity Type | Organization
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Legal Business Name | DELAWARE HEART AND VASCULAR GROUP LLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 94A OMEGA DR
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City | NEWARK
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State | DE
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Zip | 19713-2066
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Country | US
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Telephone | 302-550-3484
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Fax | 302-556-3484
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Provider Business Mailing Address
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Address Line | 94A OMEGA DR
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City | NEWARK
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State | DE
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Zip | 19713-2066
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Country | US
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Telephone | 302-550-3484
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Fax | 302-556-3484
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANTONY LESLIE INNASIMUTHU
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Credential | MD
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Telephone | 412-867-8396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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