Provider Demographics
NPI:1346385671
Name:CHRISTIANA CENTER FOR WOMENS WELLNESS, P,A.
Entity Type:Organization
Organization Name:CHRISTIANA CENTER FOR WOMENS WELLNESS, P,A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-368-3257
Mailing Address - Street 1:1082 OLD CHURCHMANS RD
Mailing Address - Street 2:STE 100
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2143
Mailing Address - Country:US
Mailing Address - Phone:302-368-3257
Mailing Address - Fax:
Practice Address - Street 1:1082 OLD CHURCHMANS RD
Practice Address - Street 2:STE 100
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2143
Practice Address - Country:US
Practice Address - Phone:302-368-3257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004253174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP00201731Medicare ID - Type UnspecifiedRAILROAD
DEG01619Medicare PIN
DEE43003Medicare UPIN