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Organization

TD ADVANCED PRACTICE PROVIDER SERVICES

Active
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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

Other

Enumeration date
10/10/2023
Last updated
08/10/2026
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