Healthcare Provider Details

I. General information

NPI: 1730229790
Provider Name (Legal Business Name): JOSEPH A DELAPA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GIUSEPPE A DELAPA

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 SMITH RIDGE RD
SOUTH SALEM NY
10590-2327
US

IV. Provider business mailing address

363 SMITH RIDGE RD
SOUTH SALEM NY
10590-2327
US

V. Phone/Fax

Practice location:
  • Phone: 914-533-6166
  • Fax: 914-533-6167
Mailing address:
  • Phone: 914-533-6166
  • Fax: 914-533-6167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number036262-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: