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Organization
TD ADVANCED PRACTICE PROVIDER SERVICES
Active
Organization
TD ADVANCED PRACTICE PROVIDER SERVICES
Active
Parent organization
20230297585
Other names
Optimal Weight Loss
Organization subpart
Yes
Provider details
NPI number
Legal business name
20230297585
Authorized official
TAMICA NICHOLE D'AGUIAR NP (MANAGER)
(856) 340-8466
Entity
Organization
Contact information
Practice address
501 SILVERSIDE RD STE 61, WILMINGTON, DE 19809-1394
(302) 308-3404
Mailing address
102 OKLAHOMA AVE, WILMINGTON, DE 19803-3236
(856) 340-8466
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
08/10/2026
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