Healthcare Provider Details
I. General information
NPI: 1629072012
Provider Name (Legal Business Name): DELPHY F DE FALCIS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/13/2005
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1736 W HAMILTON ST
ALLENTOWN PA
18104-5656
US
IV. Provider business mailing address
24 S 18TH ST
ALLENTOWN PA
18104-5622
US
V. Phone/Fax
- Phone: 610-628-8372
- Fax: 610-628-8648
- Phone: 610-628-8372
- Fax: 610-628-8648
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | OS008455L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: