Provider Demographics
NPI:1639300676
Name:DELAWARE NEUROSCIENCE SPECIALISTS
Entity Type:Organization
Organization Name:DELAWARE NEUROSCIENCE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:302-731-3017
Mailing Address - Street 1:774 CHRISTIANA RD STE 201B
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4221
Mailing Address - Country:US
Mailing Address - Phone:302-731-3017
Mailing Address - Fax:
Practice Address - Street 1:774 CHRISTIANA RD STE 201B
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4221
Practice Address - Country:US
Practice Address - Phone:302-731-3017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE231201Medicaid
DEB49042Medicare UPIN