Provider Demographics
NPI:1164445169
Name:DELAWARE DIAGNOSTIC SERVICES, INC.
Entity Type:Organization
Organization Name:DELAWARE DIAGNOSTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF IMAGING SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-892-6200
Mailing Address - Street 1:PO BOX 5020
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-0020
Mailing Address - Country:US
Mailing Address - Phone:302-892-6200
Mailing Address - Fax:302-892-6206
Practice Address - Street 1:4512 KIRKWOOD HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5123
Practice Address - Country:US
Practice Address - Phone:302-892-6200
Practice Address - Fax:302-892-6206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE207UN0901X, 2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000908602Medicaid
DE0000908602Medicaid