MEDICARE: RADNON FOCUSED COMMUNITY SYSTEMS

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	103TM1800X	Intellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number	:	1942022959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADNON FOCUSED COMMUNITY SYSTEMS

Provider Business Mailing Address
First Line	:	3906 CONCORD PIKE STE E
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19803-1733
Country	:	US
Telephone Number	:	302-440-6112
Fax Number	:

Provider Business Practice Location Address
First Line	:	3906 CONCORD PIKE STE E
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19803-1733
Country	:	US
Telephone Number	:	302-440-6112
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TAM GEORGE
Credential	:
Telephone Number	:	302-440-6112

Provider Enumeration Date	:	10/30/2024
Last Update Date	:	10/30/2024

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Directions to “RADNON FOCUSED COMMUNITY SYSTEMS ” Practice Location

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