Provider Demographics
NPI:1679679799
Name:DELAWARE DIGESTIVE DISEASES ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DELAWARE DIGESTIVE DISEASES ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BURTON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-629-5553
Mailing Address - Street 1:904 MIDDLEFORD RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:904 MIDDLEFORD RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3604
Practice Address - Country:US
Practice Address - Phone:302-629-5553
Practice Address - Fax:302-536-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0001972207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000174401Medicaid
DE0000174401Medicaid
DEB66268Medicare UPIN