University Of De Pt Clinic | |
540 S College Ave Ste 160 Newark DE 19713-1302 | |
(302) 831-8893 | |
(302) 831-4468 |
Full Name | University Of De Pt Clinic |
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Speciality | Clinic/Center |
Location | 540 S College Ave Ste 160, Newark, Delaware |
Authorized Official Name and Position | Airelle Hunter (DIRECTOR OF CLINICAL SERVICES) |
Authorized Official Contact | 3028312705 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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University Of De Pt Clinic 540 S College Ave Ste 160 Newark DE 19713-1302 Ph: (302) 831-8893 | University Of De Pt Clinic 540 S College Ave Ste 160 Newark DE 19713-1302 Ph: (302) 831-8893 |
NPI Number | 1679614390 |
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Provider Enumeration Date | 02/08/2007 |
Last Update Date | 11/30/2023 |
Medicare PECOS PAC ID | 4486733599 |
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Medicare Enrollment ID | O20130306000384 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679614390 | NPI | - | NPPES |
1000035397 | Medicaid | DE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR0400X | Clinic/center - Rehabilitation | J1-0000851 (Delaware) | Primary |
Provider Name | Beatrice M Gaynor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730188467 PECOS PAC ID: 8325126931 Enrollment ID: I20080423000183 |
Provider Name | Carolyn G Haines |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326277823 PECOS PAC ID: 9133274145 Enrollment ID: I20090827000076 |
Provider Name | Jenny L Hughes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942271705 PECOS PAC ID: 9638211568 Enrollment ID: I20100115000070 |
Provider Name | Bradley J Sandella |
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Provider Type | Practitioner - Sports Medicine |
Provider Identifiers | NPI Number: 1184751042 PECOS PAC ID: 1355534793 Enrollment ID: I20120606000398 |
Provider Name | Tracey K Sinibaldi |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1891993283 PECOS PAC ID: 8628162922 Enrollment ID: I20130107000103 |
Provider Name | Julia Jordan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215362421 PECOS PAC ID: 5496985707 Enrollment ID: I20140306001915 |
Provider Name | Sharon B Collison |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1548382013 PECOS PAC ID: 7618109281 Enrollment ID: I20140414000725 |
Provider Name | Susan Beth Conaty-buck |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407913197 PECOS PAC ID: 7618955402 Enrollment ID: I20150519000653 |
Provider Name | Chaney Goodner Stewman |
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Provider Type | Practitioner - Sports Medicine |
Provider Identifiers | NPI Number: 1932333820 PECOS PAC ID: 8224251921 Enrollment ID: I20170111001468 |
Provider Name | Stephanie B Hall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477741296 PECOS PAC ID: 7719034438 Enrollment ID: I20170706002458 |
Provider Name | Julia M Nutter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528331774 PECOS PAC ID: 7517129836 Enrollment ID: I20200501000018 |
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