| Family Practice Associates, Pa | |
|
1100 S Broom St Wilmington DE 19805-4585 | |
| (302) 656-5416 | |
| Not Available |
| Full Name | Family Practice Associates, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1100 S Broom St, Wilmington, Delaware |
| Authorized Official Name and Position | Edward R Sobel (PRESIDENT) |
| Authorized Official Contact | 3026565416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Associates, Pa 1100 S Broom St Wilmington DE 19805-4585 Ph: (302) 656-5416 | Family Practice Associates, Pa 1100 S Broom St Wilmington DE 19805-4585 Ph: (302) 656-5416 |
| NPI Number | 1053426692 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7012985641 |
|---|---|
| Medicare Enrollment ID | O20040922000188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053426692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1989015228 (Delaware) | Primary |
| Provider Name | Josefina S Cancino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154404143 PECOS PAC ID: 3779483516 Enrollment ID: I20040109000472 |
| Provider Name | Jerry P Gluckman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629070370 PECOS PAC ID: 6204838733 Enrollment ID: I20070212000603 |
| Provider Name | David M Krasner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629017447 PECOS PAC ID: 8325127277 Enrollment ID: I20101230000145 |
| Provider Name | Lindsay H Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265815526 PECOS PAC ID: 8022322981 Enrollment ID: I20150810001853 |
| Provider Name | Leila M Gaines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861596405 PECOS PAC ID: 0547310997 Enrollment ID: I20220105000492 |
| Provider Name | Matthew Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558649061 PECOS PAC ID: 1456578111 Enrollment ID: I20240127000474 |
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