Basic Information
| Provider Information | |||||||||
| NPI: | 1205168267 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOWICZ | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSN, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 PENNS WAY | ||||||||
| Address2: | SUITE 412 | ||||||||
| City: | NEW CASTLE | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026522455 | ||||||||
| FaxNumber: | 3023226251 | ||||||||
| Practice Location | |||||||||
| Address1: | 908 E 16TH ST STE B | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198025145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025751414 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2010 | ||||||||
| LastUpdateDate: | 04/08/2016 | ||||||||
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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 | 163WG0000X | L1-0037161 | DE | N | Nursing Service Providers | Registered Nurse | General Practice | 363L00000X | LG-0000528 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.