1093733685 NPI number — EDWARD STANCHI M.D.

Table of content: EDWARD STANCHI M.D. (NPI 1093733685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093733685 NPI number — EDWARD STANCHI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STANCHI
Provider First Name:
EDWARD
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093733685
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 PENNY LANE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19803-4023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-674-3366
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 W DIVISION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOVER
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19904-2760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-674-3366
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  C1-0003831 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 41147 . This is a "PSYCHISTRY BOARD NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000930161 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427083583 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1000032863 . This is a "DE PHY, CARE FOR AQUILA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com