Provider Demographics
NPI:1053426692
Name:FAMILY PRACTICE ASSOCIATES, PA
Entity type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-656-5416
Mailing Address - Street 1:1100 S BROOM ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-4585
Mailing Address - Country:US
Mailing Address - Phone:302-656-5416
Mailing Address - Fax:
Practice Address - Street 1:1100 S BROOM ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4585
Practice Address - Country:US
Practice Address - Phone:302-656-5416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1989015228207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty