| Peninsula Health Llc | |
|
26744 John J. Williams Hwy Suite #7 Millsboro DE 19966 | |
| (302) 945-0440 | |
| (302) 945-0442 |
| Full Name | Peninsula Health Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 26744 John J. Williams Hwy, Millsboro, Delaware |
| Authorized Official Name and Position | Terri L Hastings (OFFICE MANAGER) |
| Authorized Official Contact | 3029450440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peninsula Health Llc 9 Greystone Dr Lewes DE 19958-9450 Ph: (302) 361-6663 | Peninsula Health Llc 26744 John J. Williams Hwy Suite #7 Millsboro DE 19966 Ph: (302) 945-0440 |
| NPI Number | 1316198062 |
|---|---|
| Provider Enumeration Date | 09/30/2008 |
| Last Update Date | 09/05/2013 |
| Medicare PECOS PAC ID | 7416019765 |
|---|---|
| Medicare Enrollment ID | O20081219000268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316198062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | C1-0005379 (Delaware) | Primary |
| Provider Name | Fadi E Damouni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245295260 PECOS PAC ID: 7719994342 Enrollment ID: I20060307000570 |
| Provider Name | Martha J Lins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033396312 PECOS PAC ID: 3274661384 Enrollment ID: I20100511000902 |
| Provider Name | Sabina Bonfadini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598148231 PECOS PAC ID: 9537476825 Enrollment ID: I20150918001735 |
| Provider Name | Cassandra A Brosnahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184161416 PECOS PAC ID: 6800163759 Enrollment ID: I20170524000507 |
| Provider Name | Kathleen C Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881118420 PECOS PAC ID: 7315208188 Enrollment ID: I20180220000347 |
| Provider Name | Mica Rae Goehner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538744230 PECOS PAC ID: 7214326875 Enrollment ID: I20211119001590 |
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