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Organization

DELAWARE PHYSIATRY

Active
Other names
Delaware NeuroRehab
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA SAMPATHKUMAR (OWNER)
(302) 387-1407
Entity
Organization

Contact information

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

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568803575
DE
Enumeration date
06/17/2021
Last updated
02/05/2025
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