NPIMap

Organization Active NPI

Corelife of Delmarva LLC

  • Family Medicine Physician
  • Salisbury, MD
National Provider Identifier
1477063386
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORELIFE OF DELMARVA LLC
Practice address
200 E Vine St Ste B
Salisbury, MD 21804-5531
Phone
(443) 358-6239
NPI assigned
Oct 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Raymond Kostkowski
Title
Ceo
Phone
(443) 679-4309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

200 E Vine St Ste B
Salisbury, MD 21804-5531

Mailing address

1111 Benfield Blvd Ste 250
Millersville, MD 21108-3005
Phone (443) 679-4309

Other practice location 1

9954 N Main St Unit 3
Berlin, MD 21811-1299
Phone (443) 358-6239

Other practice location 2

508 Idlewild Ave Ste 3
Easton, MD 21601-3834
Phone (443) 358-6239

Other practice location 3

30265 Commerce Dr Unit 102
Millsboro, DE 19966-3594
Phone (443) 679-4433

Other names 1

  • CoreLife Doing business as

National Provider Directory

National Provider Directory

Locations

30265 Commerce Dr
Millsboro, DE 19966
Phone (302) 629-5050

9954 N Main St
Bldg 2UNI
Berlin, MD 21811

1496 Still Meadow Blvd
Ste De
Salisbury, MD 21804

1496 Still Meadow Blvd
Salisbury, MD 21804
Phone (410) 572-2888

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1477063386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BENFIELD BLVD STE 250",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211083005",
            "telephone_number": "443-679-4309",
            "fax_number": "855-772-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E VINE ST STE B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045531",
            "telephone_number": "443-358-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9954 N Main St Unit 3",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "MD",
            "postal_code": "218111299",
            "country_code": "US",
            "telephone_number": "443-358-6239",
            "fax_number": "443-225-4869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "508 Idlewild Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216013834",
            "country_code": "US",
            "telephone_number": "443-358-6239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30265 Commerce Dr Unit 102",
            "address_purpose": "LOCATION",
            "city": "Millsboro",
            "state": "DE",
            "postal_code": "199663594",
            "country_code": "US",
            "telephone_number": "443-679-4433",
            "fax_number": "302-219-7727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORELIFE OF DELMARVA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "KOSTKOWSKI",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-679-4309"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CoreLife",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.