Nicholas O Biasotto DO PA

Organization Active NPI Family Medicine Physician · Newark, DE

NPI 1629401435 · NPPES record last updated Aug 15, 2013

Key facts

NPI
1629401435
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
C2-0002000 (DE)
Legal business name
NICHOLAS O BIASOTTO DO PA
Practice address
620 Stanton Christiana Rd
Ste 205
Newark, DE 19713-2133
Phone
(302) 998-1284
Fax
(302) 998-1267
NPI assigned
Aug 15, 2013
Organization subpart
No

Authorized official

Name
Nicholas Biasotto
Title
Owner
Phone
(302) 998-1284

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in DE

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130815000659 DE Part B Supplier - Clinic/Group Practice 5991947251 Receives reassigned benefits from 1 practitioner
Practice locations: Newark, DE

National Provider Directory

Locations

620 Stanton Christiana Rd
Newark, DE 19713
Phone (302) 225-6110

620 Stanton Christiana Rd
Ste 205
Newark, DE 19713
Phone (302) 998-1211

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X C2-0002000 DE Yes

Addresses

Primary practice location

620 Stanton Christiana Rd
Ste 205
Newark, DE 19713-2133

Mailing address

620 Stanton Christiana Rd
Ste 205
Newark, DE 19713-2133
Phone (302) 998-1284

Other providers in Newark, DE

All providers in Newark, DE · Family Medicine Physician in Delaware

Sources for this page

Verify at the official NPI Registry.