Basic Information
| Provider Information | |||||||||
| NPI: | 1700509296 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYRNES | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | IV | ||||||||
| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4735 OGLETOWN STANTON RD STE 1250 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026230200 | ||||||||
| FaxNumber: | 3026230117 | ||||||||
| Practice Location | |||||||||
| Address1: | 4735 OGLETOWN STANTON RD STE 1250 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026230200 | ||||||||
| FaxNumber: | 3026230117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2022 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | L1-0036577 | DE | N | Nursing Service Providers | Registered Nurse | 363LF0000X | LG-0012102 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.