1679916522 NPI number — CHRISTIANA CARE

Table of content: (NPI 1679916522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679916522 NPI number — CHRISTIANA CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTIANA CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679916522
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTER HEIGHTS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19801-1024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-304-6437
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CORTESE
Authorized Official First Name:
DANA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
FAMILY NURSE PRACTITIONER
Authorized Official Telephone Number:
610-304-6437

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X , with the licence number:  LG-0000650 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)