Provider Demographics
NPI:1508652447
Name:DELLA FAVE, SKYLER
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:
Last Name:DELLA FAVE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 MONTICO RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4007
Mailing Address - Country:US
Mailing Address - Phone:201-841-4331
Mailing Address - Fax:
Practice Address - Street 1:19 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:TALLEYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19803-1838
Practice Address - Country:US
Practice Address - Phone:302-703-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010824363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner