Provider Demographics
NPI:1215007869
Name:NANTICOKE CARDIOLOGY, P.A.
Entity Type:Organization
Organization Name:NANTICOKE CARDIOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-629-9099
Mailing Address - Street 1:200 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-5764
Mailing Address - Country:US
Mailing Address - Phone:302-629-9099
Mailing Address - Fax:302-629-9499
Practice Address - Street 1:200 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5764
Practice Address - Country:US
Practice Address - Phone:302-629-9099
Practice Address - Fax:302-629-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE747183Medicare ID - Type Unspecified