Provider Demographics
NPI:1699879007
Name:NIEVA T. DUQUE, M.D., P.A.
Entity type:Organization
Organization Name:NIEVA T. DUQUE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELIZZA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DIMAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-655-2048
Mailing Address - Street 1:1010 N BANCROFT PKWY
Mailing Address - Street 2:SUITE LL3
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2690
Mailing Address - Country:US
Mailing Address - Phone:302-655-2048
Mailing Address - Fax:302-543-8945
Practice Address - Street 1:1010 N BANCROFT PKWY
Practice Address - Street 2:SUITE LL3
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2690
Practice Address - Country:US
Practice Address - Phone:302-655-2048
Practice Address - Fax:302-543-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG00065Medicare PIN