Provider Demographics
NPI:1780462374
Name:RHEUMATOLOGY AND FIBROMYALGIA CENTER OF EXCELLENCE
Entity type:Organization
Organization Name:RHEUMATOLOGY AND FIBROMYALGIA CENTER OF EXCELLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-660-1100
Mailing Address - Street 1:29 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1494
Mailing Address - Country:US
Mailing Address - Phone:302-513-0550
Mailing Address - Fax:800-524-6869
Practice Address - Street 1:29 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1494
Practice Address - Country:US
Practice Address - Phone:302-513-0550
Practice Address - Fax:800-524-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology