Provider Demographics
NPI:1881899300
Name:BIRARDI, THERESA SABRINA (DO)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:SABRINA
Last Name:BIRARDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 PHILADELPHIA PIKE
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2430
Mailing Address - Country:US
Mailing Address - Phone:302-428-4110
Mailing Address - Fax:302-798-6672
Practice Address - Street 1:2401 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2430
Practice Address - Country:US
Practice Address - Phone:302-428-4110
Practice Address - Fax:302-798-6672
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015282207Q00000X
PAOT012071207V00000X
DEC2-0013225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology