| Diamond State Primary Care, LLC | |
|
1400 Peoples Plz Ste 305 Newark DE 19702-5708 | |
| (302) 838-2210 | |
| (302) 838-2129 |
| Full Name | Diamond State Primary Care, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1400 Peoples Plz Ste 305, Newark, Delaware |
| Authorized Official Name and Position | Imelyn Fernandez Lahey (OWNER) |
| Authorized Official Contact | 3028382210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diamond State Primary Care, LLC 1400 Peoples Plz Ste 305 Newark DE 19702-5708 Ph: (603) 991-4824 | Diamond State Primary Care, LLC 1400 Peoples Plz Ste 305 Newark DE 19702-5708 Ph: (302) 838-2210 |
| NPI Number | 1386246940 |
|---|---|
| Provider Enumeration Date | 11/09/2020 |
| Last Update Date | 10/15/2026 |
| Certification Date | 10/15/2026 |
| Medicare PECOS PAC ID | 3870904931 |
|---|---|
| Medicare Enrollment ID | O20201120000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386246940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Torianne Miranda Yetter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760851299 PECOS PAC ID: 6709189582 Enrollment ID: I20170214001067 |
| Provider Name | Imelyn F Lahey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780999300 PECOS PAC ID: 0648401067 Enrollment ID: I20180122001167 |
| Provider Name | Kathryn Caricchio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912718818 PECOS PAC ID: 6204336860 Enrollment ID: I20250826005000 |
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