Individual
IRENE RAISIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4755 OGLETOWN STANTON RD, DEPARTMENT OF RADIOLOGY, NEWARK, DE 19718-2200
(302) 733-1806
(302) 733-1808
Mailing address
4755 OGLETOWN STANTON RD, DEPARTMENT OF RADIOLOGY, NEWARK, DE 19718-2200
(302) 733-1806
(302) 733-1808
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C1-0003191
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000112101
—
DE
01
—
300027132
RAILROAD MEDICARE #
—
Enumeration date
03/21/2006
Last updated
04/03/2013
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