Individual
ALICIA RENEE EDELBLUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4755 OGLETOWN STANTON RD, NEWARK, DE 19718-2200
(610) 406-7662
Mailing address
4299 RIDERS LN, UPPER CHICHESTER, PA 19061-2644
(610) 406-7662
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
DE C5 0000687
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE C50000687
DE STATE BOARD OF MEDICINE
DE
Enumeration date
11/06/2009
Last updated
04/17/2013
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