Basic Information
| Provider Information | |||||||||
| NPI: | 1093733685 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STANCHI | ||||||||
| FirstName: | EDWARD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 PENNY LANE CT | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198034023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026743366 | ||||||||
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| Practice Location | |||||||||
| Address1: | 630 W DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199042760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026743366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 08/26/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | C1-0003831 | DE | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | MD2474 | 01 | DE | DEA DE | OTHER | 41147 | 01 | PSYCHISTRY BOARD NUMBER | OTHER | 0000930161 | 05 | DE | MEDICAID | 1427083583 | 05 | DE | MEDICAID | M34576 | 01 | MD | DEA MD | OTHER | 1000032863 | 01 | DE | DE PHY, CARE FOR AQUILA | OTHER |