Organization
HENLOPEN CARDIOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASI BOLOURCHI (OFFICE MANAGER)
(302) 645-7672
Entity
Organization
Contact information
Practice address
123 PENNSYLVANIA AVE, SEAFORD, DE 19973-3829
(302) 628-2687
Mailing address
18958 COASTAL HWY, REHOBOTH BEACH, DE 19971-9791
(302) 645-7672
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
C10001853
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001083602
—
DE
01
—
CB3761
RAILROAD MEDICARE
—
Enumeration date
07/10/2006
Last updated
11/06/2007
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