Provider Demographics
NPI:1093733685
Name:STANCHI, EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:STANCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PENNY LANE CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4023
Mailing Address - Country:US
Mailing Address - Phone:302-674-3366
Mailing Address - Fax:
Practice Address - Street 1:630 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2760
Practice Address - Country:US
Practice Address - Phone:302-674-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00038312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
41147OtherPSYCHISTRY BOARD NUMBER
DE0000930161Medicaid
DE1427083583Medicaid
DE1000032863OtherDE PHY, CARE FOR AQUILA
MDM34576OtherDEA MD
DE1000032863OtherDE PHY, CARE FOR AQUILA
DE1000032863OtherDE PHY, CARE FOR AQUILA
000J72P14Medicare UPIN
DEMD2474OtherDEA DE