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
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