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General NPI Number Information
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NPI Number | 1164580387
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Entity Type | Organization
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Legal Business Name | DELLON INSTITUTE FOR PERIPHERAL NERVE SURGERY
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1269 BEACON ST 2ND FLOOR
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City | BROOKLINE
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State | MA
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Zip | 02446-5245
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Country | US
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Telephone | 781-721-0500
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Fax | 781-721-5719
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Provider Business Mailing Address
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Address Line | 1269 BEACON ST 2ND FLOOR
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City | BROOKLINE
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State | MA
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Zip | 02446-5245
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Country | US
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Telephone | 781-721-0500
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Fax | 781-721-5719
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Authorized Official
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Title or Position | COOWNER
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Name | DR. VIRGINIA S HUNG
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Credential | MD
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Telephone | 781-721-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 218005
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License Number State | MA
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