Diamond State Chiropractic Pa | |
1101 Twin C Ln Ste 201 Newark DE 19713-2159 | |
(302) 892-9355 | |
(302) 892-3494 |
Full Name | Diamond State Chiropractic Pa |
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Speciality | Chiropractor |
Location | 1101 Twin C Ln Ste 201, Newark, Delaware |
Authorized Official Name and Position | Todd H Bogos (OWNER) |
Authorized Official Contact | 3027775551 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Diamond State Chiropractic Pa 1101 Twin C Ln Ste 201 Newark DE 19713-2159 Ph: (302) 892-9355 | Diamond State Chiropractic Pa 1101 Twin C Ln Ste 201 Newark DE 19713-2159 Ph: (302) 892-9355 |
NPI Number | 1952346538 |
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Provider Enumeration Date | 06/18/2006 |
Last Update Date | 06/25/2025 |
Medicare PECOS PAC ID | 5991769077 |
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Medicare Enrollment ID | O20041118000082 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952346538 | NPI | - | NPPES |
Provider Name | Gregory Joseph Serge |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1033166707 PECOS PAC ID: 5799721940 Enrollment ID: I20050628001339 |
Provider Name | John W Ashby |
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Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1740229046 PECOS PAC ID: 7719021559 Enrollment ID: I20100218000013 |
Provider Name | Debra K Brady |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1740338318 PECOS PAC ID: 0143416420 Enrollment ID: I20101129000747 |
Provider Name | Todd H Bogos |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1801837851 PECOS PAC ID: 7416990049 Enrollment ID: I20141016002090 |
Provider Name | John R Booth |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1487085924 PECOS PAC ID: 0345543070 Enrollment ID: I20160129000651 |
Provider Name | Michael J Edenzon |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1790860476 PECOS PAC ID: 5799810628 Enrollment ID: I20220623001143 |
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