Provider Demographics
NPI:1124334123
Name:ARTHRITIS & OSTEOPOROSIS CENTER LLC
Entity type:Organization
Organization Name:ARTHRITIS & OSTEOPOROSIS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-628-8300
Mailing Address - Street 1:1350 MIDDLEFORD RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3664
Mailing Address - Country:US
Mailing Address - Phone:302-628-8300
Mailing Address - Fax:302-628-8400
Practice Address - Street 1:1350 MIDDLEFORD RD
Practice Address - Street 2:SUITE 502
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3664
Practice Address - Country:US
Practice Address - Phone:302-628-8300
Practice Address - Fax:302-628-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10006778207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE196156OtherGROUP PTAN