Healthcare Provider Details

I. General information

NPI: 1417148362
Provider Name (Legal Business Name): DELCINE ANN SOOD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DELCINE ANN ABRAHAM DO

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BRACE RD STE C1
CHERRY HILL NJ
08034-2600
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-428-4100
  • Fax: 856-428-5748
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number25MB08665100
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MB08665100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: