Organization
BRANDYWINE PEDIATRICS, P.A.
Active
Organization
BRANDYWINE PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILENE BOUDREAUX M.D. (PRESIDENT)
(302) 479-0294
Entity
Organization
Contact information
Practice address
3521 SILVERSIDE RD, 1F QUILLEN BLDG, WILMINGTON, DE 19810-4900
(302) 479-0294
(302) 478-2637
Mailing address
3521 SILVERSIDE RD, 1F QUILLEN BLDG, WILMINGTON, DE 19810-4900
(302) 479-0294
(302) 478-2637
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000684202
—
DE
Enumeration date
08/30/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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