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LIFESPAN MEDICAL SERVICES LLC NPI 1427131382


NPI Information

NPI: 1427131382
Provider Name: LIFESPAN MEDICAL SERVICES LLC
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
1125 FORREST AVE
DOVER, DE
ZIP 19904
Phone: (302) 346-0100
Get Directions

LIFESPAN MEDICAL SERVICES LLC is a geriatric medicine internal medicine in Dover, DE. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. LIFESPAN MEDICAL SERVICES LLC NPI is 1427131382. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1125 FORREST AVE
DOVER, DE
ZIP 19904-483
Phone: (302) 346-0100
Fax: (302) 346-0103

The provider's authorized official is Harsha Tankala .
The authorized official title is Owner/president and has the following contact phone number (302) 678-0950.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 6/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0300XInternal MedicineGeriatric MedicineC1-0005962DELAWAREYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11000041898MEDICAIDDELAWARE
2=========OTHERDELAWARETAX ID#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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