Provider Demographics
NPI:1356403539
Name:NEPHROLOGY CONSULTANTS PA
Entity type:Organization
Organization Name:NEPHROLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:GARG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-355-2383
Mailing Address - Street 1:2006 LIMESTONE RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5553
Mailing Address - Country:US
Mailing Address - Phone:302-355-2383
Mailing Address - Fax:
Practice Address - Street 1:2006 LIMESTONE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5553
Practice Address - Country:US
Practice Address - Phone:302-355-2383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007344207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000035991Medicaid
MD174NMedicare ID - Type UnspecifiedGROUP #
DE1000035991Medicaid