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General NPI Number Information
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NPI Number | 1386904266
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Entity Type | Organization
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Legal Business Name | DANIEL L. DELLATORRE MD PC
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Dates
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Enumeration Date | 05/24/2012
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Last Update Date | 05/24/2012
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Provider Practice Location Address
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Address Line | 5454 WISCONSIN AVENUE SUITE 855
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6948
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Country | US
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Telephone | 301-652-2585
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Fax | 301-652-0380
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Provider Business Mailing Address
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Address Line | 5454 WISCONSIN AVENUE SUITE 855
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6948
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Country | US
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Telephone | 301-652-2585
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Fax | 301-652-0380
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Authorized Official
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Title or Position | DIRECTOR/PHYSICIAN
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Name | DANIEL LOUIS DELLATORRE
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Credential | MD
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Telephone | 301-652-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D23131
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License Number State | MD
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