1487739371 NPI number — DORA DELSORDO A.P.N., C.

Table of content: DORA DELSORDO A.P.N., C. (NPI 1487739371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487739371 NPI number — DORA DELSORDO A.P.N., C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELSORDO
Provider First Name:
DORA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
A.P.N., C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1487739371
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 WHITE MEADOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBOROUGH
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08844-1600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-371-1152
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
195 LITTLE ALBANY ST
Provider Second Line Business Practice Location Address:
CANCER INSTITUTE OF NJ - PEDIATRIC HEME/ONC
Provider Business Practice Location Address City Name:
NEW BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08901-1914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-235-8498
Provider Business Practice Location Address Fax Number:
732-235-6462
Provider Enumeration Date:
10/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SX0204X , with the licence number:  26NO11260600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X , with the licence number: 26NO11260600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7829001 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".