Healthcare Provider Details

I. General information

NPI: 1396366571
Provider Name (Legal Business Name): MARTIN CHAN DELATORRE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3788 HECKTOWN RD STE 210
EASTON PA
18045-2355
US

IV. Provider business mailing address

2100 MACK BLVD FL 4
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 484-546-5900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberOS021617
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: