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NPI Code Detail

MEDICARE: DALESQUI BERTIER LPN

MEDICARE: DALESQUI BERTIER LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NursePN293758PA

General Provider Information

NPI Number : 1790464113
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALESQUI BERTIER LPN
Provider Business Mailing Address
First Line : 5000 PARKSIDE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-4714
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5000 PARKSIDE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-4714
Country : US
Telephone Number : 215-879-6116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2023
Last Update Date : 07/13/2023

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Directions to “ DALESQUI BERTIER LPN” Practice Location

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