Provider Demographics
NPI:1013076991
Name:RAINBOW PEDIATRICS
Entity Type:Organization
Organization Name:RAINBOW PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:VIBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-381-5528
Mailing Address - Street 1:21141 STERLING AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-5571
Mailing Address - Country:US
Mailing Address - Phone:302-856-6967
Mailing Address - Fax:302-855-0744
Practice Address - Street 1:21141 STERLING AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-5571
Practice Address - Country:US
Practice Address - Phone:302-856-6967
Practice Address - Fax:302-855-0744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005413208000000X
DEC10006252208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001147901Medicaid
DE1000041255Medicaid
DE0000904101Medicaid