Provider Demographics
NPI:1245316694
Name:AFFINITY HEALTH, L.L.C.
Entity type:Organization
Organization Name:AFFINITY HEALTH, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:BLUMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:302-652-7733
Mailing Address - Street 1:5301 LIMESTONE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1250
Mailing Address - Country:US
Mailing Address - Phone:302-234-8982
Mailing Address - Fax:302-234-8984
Practice Address - Street 1:5301 LIMESTONE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1250
Practice Address - Country:US
Practice Address - Phone:302-234-8982
Practice Address - Fax:302-234-8984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000212103TC0700X
DEB10000190103TC0700X
DEB10000662103TC0700X
DEB10000201103TC0700X
DEPC0000337101YM0800X
DEB1-0000210103TC0700X
DE2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE562511MDOtherBCBS
DE562511PHDOtherBCBS