MEDICARE: JUAN P GADEA MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	C10T00212	DE

General Provider Information

NPI Number	:	1710976139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUAN P GADEA MD PA

Provider Business Mailing Address
First Line	:	179 W CHESTNUT HILL RD
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19713-2210
Country	:	US
Telephone Number	:	302-731-0858
Fax Number	:	302-731-0027

Provider Business Practice Location Address
First Line	:	179 W CHESTNUT HILL RD
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19713-2210
Country	:	US
Telephone Number	:	302-731-0858
Fax Number	:	302-731-0027

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUAN R GADEA
Credential	:	MD
Telephone Number	:	302-731-0858

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	01/03/2012

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