Diamond State Primary Care, Llc | |
1400 Peoples Plz Ste 305 Newark DE 19702-5708 | |
(302) 838-2210 | |
(302) 838-2129 |
Full Name | Diamond State Primary Care, Llc |
---|---|
Speciality | Family Medicine |
Location | 1400 Peoples Plz Ste 305, Newark, Delaware |
Authorized Official Name and Position | Imelyn Fernandez Lahey (OWNER) |
Authorized Official Contact | 3028382210 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Diamond State Primary Care, Llc 1400 Peoples Plz Ste 305 Newark DE 19702-5708 Ph: (302) 838-2210 | Diamond State Primary Care, Llc 1400 Peoples Plz Ste 305 Newark DE 19702-5708 Ph: (302) 838-2210 |
NPI Number | 1386246940 |
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Provider Enumeration Date | 11/09/2020 |
Last Update Date | 12/03/2020 |
Medicare PECOS PAC ID | 3870904931 |
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Medicare Enrollment ID | O20201120000163 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386246940 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Imelyn F Lahey |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780999300 PECOS PAC ID: 0648401067 Enrollment ID: I20180122001167 |
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