| First State Endocrinology, Pa | |
|
774 Christiana Rd Ste 109 Newark DE 19713-4248 | |
| (302) 444-8156 | |
| (302) 731-8158 |
| Full Name | First State Endocrinology, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 774 Christiana Rd Ste 109, Newark, Delaware |
| Authorized Official Name and Position | Ripudaman S Hundal (PHYSICIAN) |
| Authorized Official Contact | 3024515610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First State Endocrinology, Pa 774 Christiana Rd Ste 109 Newark DE 19713-4248 Ph: (302) 444-8156 | First State Endocrinology, Pa 774 Christiana Rd Ste 109 Newark DE 19713-4248 Ph: (302) 444-8156 |
| NPI Number | 1295009660 |
|---|---|
| Provider Enumeration Date | 03/02/2012 |
| Last Update Date | 08/19/2021 |
| Medicare PECOS PAC ID | 3678736659 |
|---|---|
| Medicare Enrollment ID | O20120601000088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295009660 | NPI | - | NPPES |
| 1073591970 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Ripudaman S Hundal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1073591970 PECOS PAC ID: 4082893102 Enrollment ID: I20110121000363 |
| Provider Name | Mayumi Lea T Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467711952 PECOS PAC ID: 5092965830 Enrollment ID: I20121101000208 |
| Provider Name | Colette Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083362396 PECOS PAC ID: 4789845272 Enrollment ID: I20220503000926 |
| Provider Name | Funmilola Olaoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548903610 PECOS PAC ID: 1759769060 Enrollment ID: I20220527000548 |
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