Healthcare Provider Details

I. General information

NPI: 1780677567
Provider Name (Legal Business Name): JOSEPH MICHAEL DELLACROCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CAPITAL WAY SUITE 390
PENNINGTON NJ
08534-2519
US

IV. Provider business mailing address

2 CAPITAL WAY SUITE 390
PENNINGTON NJ
08534-2519
US

V. Phone/Fax

Practice location:
  • Phone: 609-818-0040
  • Fax: 609-818-0049
Mailing address:
  • Phone: 609-818-0040
  • Fax: 609-818-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMA52630
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: