Provider Demographics
NPI:1265515464
Name:IRENE C. VIOLA, MD, PA
Entity type:Organization
Organization Name:IRENE C. VIOLA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:C
Authorized Official - Last Name:VIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-644-1450
Mailing Address - Street 1:1606 SAVANNAH RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1656
Mailing Address - Country:US
Mailing Address - Phone:302-644-1450
Mailing Address - Fax:302-644-0650
Practice Address - Street 1:1606 SAVANNAH RD
Practice Address - Street 2:SUITE 8
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1656
Practice Address - Country:US
Practice Address - Phone:302-644-1450
Practice Address - Fax:302-644-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006063207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000032913OtherDELAWARE PHYS CARE
DEDC1004OtherRAILROAD MEDICARE
DE1000032913Medicaid
DE2363473000OtherAMERIHEALTH-PCP
DE2291852000OtherAMERIHEALTH RHEU
DE=========OtherAETNA
DE=========OtherALLIANCE, MAMSI, OPT CHOI
DE=========OtherUNITED HEALTH CARE
DE=========OtherBCBS DE
DE=========OtherCOVENTRY
DE=========OtherTRICARE
DE1000032913Medicaid