Provider Demographics
NPI:1427116086
Name:FAMILY MEDICINE AT GREENHILL
Entity type:Organization
Organization Name:FAMILY MEDICINE AT GREENHILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MONGILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-429-5870
Mailing Address - Street 1:1010 N BANCROFT PKWY STE 113
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805
Mailing Address - Country:US
Mailing Address - Phone:302-429-5870
Mailing Address - Fax:302-429-9284
Practice Address - Street 1:213 GREENHILL AVE STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1800
Practice Address - Country:US
Practice Address - Phone:302-429-5870
Practice Address - Fax:302-429-9284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty