Provider Demographics
NPI:1386681260
Name:PIACENTINE, JAMES A (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:PIACENTINE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:200 HYGEIA DR STE 2300
Mailing Address - Street 2:CCHS PHYSICIAN CONTRACTING
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:STE 5A43
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-623-0188
Practice Address - Fax:302-733-5640
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2016-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC20006482207R00000X
DEC2-0006482207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1386681260Medicaid
DE1386681260Medicaid
DE020206ZAG8Medicare PIN