# DELAWARE PHYSIATRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Delaware NeuroRehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174192827
- **Authorized official:** JESSICA SAMPATHKUMAR (OWNER)
- **Authorized official phone:** (302) 387-1407

## Contact information

- **Practice address:** 1221 COLLEGE PARK DR STE 203, DOVER, DE 19904-8727
- **Practice address phone:** (302) 387-1407
- **Practice address fax:** (877) 381-4173
- **Mailing address:** 1221 COLLEGE PARK DR STE 203, DOVER, DE 19904-8727
- **Mailing address phone:** (302) 387-1407
- **Mailing address fax:** (877) 381-4173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | — | NULL | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |

## Other

- **Enumeration date:** 06/17/2021
- **Last updated:** 02/05/2025