Provider Demographics
NPI:1962691436
Name:CNS OCCUPATIONAL MEDICINE OF DELAWARE
Entity type:Organization
Organization Name:CNS OCCUPATIONAL MEDICINE OF DELAWARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-515-1708
Mailing Address - Street 1:20797 PROFESSIONAL PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-3198
Mailing Address - Country:US
Mailing Address - Phone:302-515-1708
Mailing Address - Fax:302-947-4433
Practice Address - Street 1:20797 PROFESSIONAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-3198
Practice Address - Country:US
Practice Address - Phone:302-515-1708
Practice Address - Fax:302-947-3344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEE67688Medicare UPIN