Provider Demographics
NPI:1073043824
Name:RELIANCE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:RELIANCE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ZEBUN
Authorized Official - Middle Name:
Authorized Official - Last Name:NISA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-907-5756
Mailing Address - Street 1:1993 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1708
Mailing Address - Country:US
Mailing Address - Phone:302-838-3100
Mailing Address - Fax:
Practice Address - Street 1:1993 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1708
Practice Address - Country:US
Practice Address - Phone:302-838-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD64083207Q00000X
MDD64019208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty