Provider Demographics
NPI:1528126844
Name:KASARDA, LYNNANNE (MD)
Entity type:Individual
Prefix:DR
First Name:LYNNANNE
Middle Name:
Last Name:KASARDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 FLORAL DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3836
Mailing Address - Country:US
Mailing Address - Phone:302-529-1010
Mailing Address - Fax:
Practice Address - Street 1:200 HYGEIA DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2049
Practice Address - Country:US
Practice Address - Phone:302-873-1701
Practice Address - Fax:302-273-4497
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003527207Q00000X
PAMD042840E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001567370Medicaid
PA809401Medicare ID - Type Unspecified
PA001567370Medicaid