Jennifer Bolick
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Newark, DE
NPI 1649973553 · NPPES record last updated Mar 22, 2023
Key facts
- NPI
- 1649973553
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 4755 Ogletown Stanton Rd
Newark, DE 19718-2200 - Phone
- (302) 733-1000
- NPI assigned
- Mar 22, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230705000715 | DE | Order and Referring Only - Internal Medicine |
0547629818 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Mailing address
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Other providers in Newark, DE
- George Mark Bohatiuk
- Leif-Erik Sheldon Bohman
- Diane C Bohner
- Jennifer Bojarski
- Traci Bolander
- Bruce M Boman
- Ashleigh Bonanno
- Donald T Bond
- Haley Lynn Bond
- Jedediah I Bondy
All providers in Newark, DE · Student in an Organized Health Care Education/Training Program in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.