Provider Demographics
NPI:1558300426
Name:DELAWARE HEART & VASCULAR, P.A.
Entity Type:Organization
Organization Name:DELAWARE HEART & VASCULAR, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIPPERT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-734-1414
Mailing Address - Street 1:PO BOX 512241
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19175-2241
Mailing Address - Country:US
Mailing Address - Phone:302-734-1414
Mailing Address - Fax:302-734-2121
Practice Address - Street 1:200 BANNING ST
Practice Address - Street 2:SUITE 340
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3485
Practice Address - Country:US
Practice Address - Phone:302-734-1414
Practice Address - Fax:302-734-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG02339Medicare PIN