| Cnmri Pa | |
|
111 Neurology Way Milford DE 19901 | |
| (302) 422-0800 | |
| Not Available |
| Full Name | Cnmri Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 111 Neurology Way, Milford, Delaware |
| Authorized Official Name and Position | Tammy M Rust (CNMRI AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 3023462491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cnmri Pa 1095 S Bradford St Dover DE 19904-4141 Ph: (302) 678-8100 | Cnmri Pa 111 Neurology Way Milford DE 19901 Ph: (302) 422-0800 |
| NPI Number | 1386788446 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 01/15/2025 |
| Certification Date | 01/15/2025 |
| Medicare PECOS PAC ID | 0143121459 |
|---|---|
| Medicare Enrollment ID | O20040120000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386788446 | NPI | - | NPPES |
| 000396902 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | John B Coll |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265439582 PECOS PAC ID: 7315027661 Enrollment ID: I20100929001445 |
| Provider Name | Robert J Varipapa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063419497 PECOS PAC ID: 3476454786 Enrollment ID: I20101004000526 |
| Provider Name | Jay I Freid |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649277005 PECOS PAC ID: 3779663026 Enrollment ID: I20101004000625 |
| Provider Name | Stephen Penny |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881691236 PECOS PAC ID: 4688754930 Enrollment ID: I20101007000141 |
| Provider Name | Peter Coveleski |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1770580144 PECOS PAC ID: 9133209471 Enrollment ID: I20101007000212 |
| Provider Name | Jay J Dave |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215159488 PECOS PAC ID: 2567511371 Enrollment ID: I20110510000532 |
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