Lifemd New England Patient Medical Care Pa | |
1209 N Orange St Wilmington DE 19801-1120 | |
(800) 875-1575 | |
Not Available |
Full Name | Lifemd New England Patient Medical Care Pa |
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Speciality | Clinic/Center |
Location | 1209 N Orange St, Wilmington, Delaware |
Authorized Official Name and Position | Eric Yecies (GENERAL COUNSEL) |
Authorized Official Contact | 6462633680 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lifemd New England Patient Medical Care Pa 236 5th Ave Ste 400 New York NY 10001-7606 Ph: (800) 852-1575 | Lifemd New England Patient Medical Care Pa 1209 N Orange St Wilmington DE 19801-1120 Ph: (800) 875-1575 |
NPI Number | 1376305847 |
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Provider Enumeration Date | 01/29/2024 |
Last Update Date | 12/17/2024 |
Medicare PECOS PAC ID | 5395270409 |
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Medicare Enrollment ID | O20241126004174 |
Identifier | Type | State | Issuer |
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1376305847 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Anthony David Puopolo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275602625 PECOS PAC ID: 5890854442 Enrollment ID: I20241126004193 |
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