Provider Demographics
NPI:1538029020
Name:NEW WAVE HEALTHCARE LLC
Entity type:Organization
Organization Name:NEW WAVE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LEITZKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-367-8765
Mailing Address - Street 1:2600 GLASGOW AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5704
Mailing Address - Country:US
Mailing Address - Phone:302-500-4412
Mailing Address - Fax:302-444-8312
Practice Address - Street 1:2600 GLASGOW AVE STE 200
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5704
Practice Address - Country:US
Practice Address - Phone:302-400-5004
Practice Address - Fax:302-444-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty