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General NPI Number Information
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NPI Number | 1639275274
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Entity Type | Organization
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Legal Business Name | QUALITY FAMILY PHYSICIANS, PA
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 722 YORKLYN RD SUITE 400
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City | HOCKESSIN
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State | DE
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Zip | 19707-8718
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Country | US
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Telephone | 302-235-2351
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Fax | 302-235-2365
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Provider Business Mailing Address
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Address Line | 722 YORKLYN RD SUITE 400
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City | HOCKESSIN
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State | DE
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Zip | 19707-8718
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Country | US
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Telephone | 302-235-2351
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Fax | 302-235-2365
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MICHELLE DIVENTI
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Credential |
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Telephone | 302-235-2351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C10005226
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License Number State | DE
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