Provider Demographics
NPI:1306893458
Name:DELAWARE RADIATION ASSOCIATES, PA
Entity type:Organization
Organization Name:DELAWARE RADIATION ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAHANIATIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-674-4401
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19903-0441
Mailing Address - Country:US
Mailing Address - Phone:414-455-4780
Mailing Address - Fax:
Practice Address - Street 1:793 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3568
Practice Address - Country:US
Practice Address - Phone:414-455-4780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000039682Medicaid
DEG02338Medicare PIN