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General NPI Number Information
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NPI Number | 1407805203
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Entity Type | Organization
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Legal Business Name | NEPHROLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 4923 OGLETOWN STANTON RD SUITE 200
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City | NEWARK
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State | DE
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Zip | 19713-2081
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Country | US
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Telephone | 32-225-0451
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Fax | 302-225-0472
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Provider Business Mailing Address
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Address Line | 4923 OGLETOWN STANTON RD SUITE 200
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City | NEWARK
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State | DE
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Zip | 19713-2081
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Country | US
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Telephone | 32-225-0451
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Fax | 302-225-0472
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTIN F GAVIN
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Credential | D.O.
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Telephone | 302-225-0451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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