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General NPI Number Information
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NPI Number | 1437185550
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Entity Type | Organization
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Legal Business Name | NANTICOKE GYN ASSOCIATES, P.A.
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 105 N FRONT ST SUITE B NANTICOKE GYN ASSOC, PA
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City | SEAFORD
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State | DE
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Zip | 19973-2707
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Country | US
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Telephone | 302-629-2434
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Fax | 302-629-2459
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Provider Business Mailing Address
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Address Line | 10 TIDEWATER DR
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City | SEAFORD
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State | DE
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Zip | 19973-9768
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Country | US
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Telephone | 302-629-2434
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Fax | 302-629-2459
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES PAUL RUPP
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Credential | M.D.
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Telephone | 302-629-2434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | C10002432
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | LH0000104
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License Number State | DE
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