Provider Demographics
NPI:1528541273
Name:LITWA, LINDSEY SUSANNE (PHD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:SUSANNE
Last Name:LITWA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 BRANDYWINE BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2306
Mailing Address - Country:US
Mailing Address - Phone:302-793-5072
Mailing Address - Fax:
Practice Address - Street 1:1311 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2306
Practice Address - Country:US
Practice Address - Phone:302-793-5072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service