| Sports Medicine Of Delaware, Inc. | |
|
102 Sleepy Hollow Dr Suite 102 Middletown DE 19709-8894 | |
| (302) 376-9711 | |
| (302) 376-9713 |
| Full Name | Sports Medicine Of Delaware, Inc. |
|---|---|
| Speciality | Internal Medicine - Sports Medicine |
| Location | 102 Sleepy Hollow Dr, Middletown, Delaware |
| Authorized Official Name and Position | Vincent Neil Disabella (PRESIDENT) |
| Authorized Official Contact | 3023769711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sports Medicine Of Delaware, Inc. 102 Sleepy Hollow Dr Suite 102 Middletown DE 19709-5841 Ph: (302) 376-9711 | Sports Medicine Of Delaware, Inc. 102 Sleepy Hollow Dr Suite 102 Middletown DE 19709-8894 Ph: (302) 376-9711 |
| NPI Number | 1790722478 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790722478 | NPI | - | NPPES |
| 2803109000 | Other | DE | AMERIHEALTH |
| 100040718 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RS0010X | Internal Medicine - Sports Medicine | C2-0005338 (Delaware) | Primary |
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