Provider Demographics
NPI:1194996058
Name:ANNE C ALDRIDGE MD PA
Entity type:Organization
Organization Name:ANNE C ALDRIDGE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-832-2181
Mailing Address - Street 1:1400 PEOPLES PLAZA
Mailing Address - Street 2:#200
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5708
Mailing Address - Country:US
Mailing Address - Phone:302-832-8181
Mailing Address - Fax:302-831-2181
Practice Address - Street 1:1400 PEOPLES PLAZA
Practice Address - Street 2:#200
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5708
Practice Address - Country:US
Practice Address - Phone:302-832-8181
Practice Address - Fax:302-832-2181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG00986Medicare PIN
DED01168Medicare UPIN