Brandywine Medical Associates, Inc. | |
1815 W 13th St Wilmington DE 19806-4054 | |
(302) 652-4705 | |
(302) 652-2917 |
Full Name | Brandywine Medical Associates, Inc. |
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Speciality | Family Medicine |
Location | 1815 W 13th St, Wilmington, Delaware |
Authorized Official Name and Position | Pasquale Fucci (PRESIDENT) |
Authorized Official Contact | 3026524705 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Brandywine Medical Associates, Inc. 1815 W 13th St Wilmington DE 19806-4054 Ph: (302) 652-4705 | Brandywine Medical Associates, Inc. 1815 W 13th St Wilmington DE 19806-4054 Ph: (302) 652-4705 |
NPI Number | 1801843768 |
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Provider Enumeration Date | 05/27/2006 |
Last Update Date | 06/14/2023 |
Medicare PECOS PAC ID | 3678560505 |
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Medicare Enrollment ID | O20040430000498 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801843768 | NPI | - | NPPES |
000998502 | Medicaid | DE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Alina A Gover |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1861449977 PECOS PAC ID: 3678596806 Enrollment ID: I20060113000132 |
Provider Name | Bryna K Milionis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043205818 PECOS PAC ID: 9436153749 Enrollment ID: I20060829000170 |
Provider Name | Jerry P Gluckman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1629070370 PECOS PAC ID: 6204838733 Enrollment ID: I20070212000603 |
Provider Name | Pasquale Fucci |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942257001 PECOS PAC ID: 4587666011 Enrollment ID: I20110527000083 |
Provider Name | Sidonie Simone Salmon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679115067 PECOS PAC ID: 9739508672 Enrollment ID: I20200928000480 |
Provider Name | Alaina Kathryn Stush |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104597483 PECOS PAC ID: 7810386562 Enrollment ID: I20211118000062 |
Provider Name | Ashlee Mcilrath |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063133114 PECOS PAC ID: 1850777541 Enrollment ID: I20231205003963 |
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