Elwyn of Pennsylvania and Delaware

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

Legal business name

ELWYN OF PENNSYLVANIA AND DELAWARE

Practice address

2502 Silverside Rd Ste 4
Wilmington, DE 19810-3740

Phone

(302) 300-6557

NPI assigned

Mar 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Donna Busch

Title

Dir. of Contracts and Credentialing

Phone

(445) 206-3028

Specialties & licenses 4

Addresses

Other identifiers 5

Other names 1

• Elwyn Delaware Employment Services Other name

Tax ID family

Elwyn Medical Services61 organizations share this tax ID, including this one

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vidyasagar R Gurijala, M.D.

  • Specialist
  • Media, PA
  • NPI 1134163454
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1306962691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-497-8972",
            "fax_number": "610-485-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 SILVERSIDE RD STE 4",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198103740",
            "telephone_number": "302-300-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELWYN OF PENNSYLVANIA AND DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "DIR. OF CONTRACTS AND CREDENTIALING",
        "authorized_official_telephone_number": "445-206-3028",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225CX0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor, Orientation and Mobility Training Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PLAN",
            "identifier": "221000664",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PLAN",
            "identifier": "222000664",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000001",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PLAN",
            "identifier": "000000664",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PLAN",
            "identifier": "000000008",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elwyn Delaware Employment Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joshua M Ellow
• Megan Jane Ellow
• Elohim Logistics, L.L.C.
• Elsmere Fire Company No. 1
• Maegan Elwood, CNA
• Emily Victoria Emamzadeh
• Alexander Callan Emberger, BCBA
• Embodied Counseling and Wellness
• Emerald Dental
• Emergency Physician Associates of Delaware PC

• Rehabilitation Psychologist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Rehabilitation Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.