Provider Demographics
NPI:1417993189
Name:CHRISTIANA CARE HEALTH INITIATIVES
Entity Type:Organization
Organization Name:CHRISTIANA CARE HEALTH INITIATIVES
Other - Org Name:CHRISTIANA CARE IMAGING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE/ BUSINESS DEV
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:RICHICHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-623-7421
Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:SUITE / 2300 FINANCE DEPARTMENT
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-623-7424
Mailing Address - Fax:302-623-7262
Practice Address - Street 1:200 HYGEIA DR
Practice Address - Street 2:SUITE 2300
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2049
Practice Address - Country:US
Practice Address - Phone:302-623-7153
Practice Address - Fax:302-623-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000145402Medicaid
DE479323Medicare ID - Type Unspecified