Provider Demographics
NPI:1710414628
Name:ARHONTAKIS, ALEXIA K (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXIA
Middle Name:K
Last Name:ARHONTAKIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALEXIA
Other - Middle Name:K
Other - Last Name:FOLLWEILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4701 OGLETOWN STANTON RD STE 2300
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2055
Mailing Address - Country:US
Mailing Address - Phone:302-731-7782
Mailing Address - Fax:302-738-5917
Practice Address - Street 1:4701 OGLETOWN STANTON RD STE 2300
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2055
Practice Address - Country:US
Practice Address - Phone:302-731-7782
Practice Address - Fax:302-738-5917
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059072363A00000X
DEC5-0011598363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103319613Medicaid