Organization
TRAUMA REHABILITATION , P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER BOHDAN BANDERA MD (OFFICER)
(302) 777-7723
Entity
Organization
Contact information
Practice address
11B TROLLEY SQ, WILMINGTON, DE 19806-3342
(302) 777-7723
(302) 777-3454
Mailing address
11B TROLLEY SQ, WILMINGTON, DE 19806-3342
(302) 777-7723
(302) 777-3454
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
C1-0003885
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000428601
—
DE
05
—
0012374630001
—
PA
Enumeration date
11/02/2006
Last updated
08/22/2020
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