Provider Demographics
NPI:1104854850
Name:CHRISTIANA INSTITUTE OF ADVANCED SURGERY, PA
Entity Type:Organization
Organization Name:CHRISTIANA INSTITUTE OF ADVANCED SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:IRGAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-892-9900
Mailing Address - Street 1:537 STANTON CHRISTIANA ROAD
Mailing Address - Street 2:STE 102
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2145
Mailing Address - Country:US
Mailing Address - Phone:302-892-9900
Mailing Address - Fax:302-892-9980
Practice Address - Street 1:537 STANTON CHRISTIANA ROAD
Practice Address - Street 2:STE 102
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2145
Practice Address - Country:US
Practice Address - Phone:302-892-9900
Practice Address - Fax:302-892-9980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE100035954Medicaid
DE7171679OtherAETNA COMMERCIAL
DE2103001000OtherPERSONAL CHOICE
DE2947295OtherAETNA MANAGED CARE
DE2103001000OtherKEYSTONE
DE2103001000OtherAMERIHEALTH
DE2103001000OtherAMERIHEALTH