Provider Demographics
NPI:1821013434
Name:CHRISTIANA NEONATAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:CHRISTIANA NEONATAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEFANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-733-2410
Mailing Address - Street 1:4745 OGLETOWN STANTON ROAD
Mailing Address - Street 2:MEDICAL ARTS PAVILION ONE SUITE 217
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-733-2374
Mailing Address - Fax:302-733-2602
Practice Address - Street 1:4745 OGLETOWN STANTON ROAD
Practice Address - Street 2:MEDICAL ARTS PAVILION ONE SUITE 217
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-733-2374
Practice Address - Fax:302-733-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001029402Medicaid