1619998622 NPI number — THOMAS A. DILIBERTO, D.O.

Table of content: (NPI 1619998622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619998622 NPI number — THOMAS A. DILIBERTO, D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS A. DILIBERTO, D.O.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DELCO RADIOLOGIC ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619998622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7780-1760
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19182-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-734-0630
Provider Business Mailing Address Fax Number:
610-734-0874

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 N LANSDOWNE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DREXEL HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19026-1114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-284-8300
Provider Business Practice Location Address Fax Number:
610-284-8312
Provider Enumeration Date:
07/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DILIBERTO
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-284-8300

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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