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NPI 1689667297

NPI 1689667297 : JOSEPH ANTHONY DELLOLIO DPM : BRONX, NY

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General NPI Number Information
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    NPI Number           |    1689667297
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH ANTHONY DELLOLIO DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/30/2005
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    Last Update Date     |    03/19/2013
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Provider Practice Location Address
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    Address Line         |    4362 WHITE PLAINS RD 
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    City                 |    BRONX
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    State                |    NY
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    Zip                  |    10466-1413
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    Country              |    US
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    Telephone            |    718-994-7054
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    Fax                  |    718-325-0798
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Provider Business Mailing Address
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    Address Line         |    4362 WHITE PLAINS RD 
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    City                 |    BRONX
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    State                |    NY
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    Zip                  |    10466-1413
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    Country              |    US
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    Telephone            |    718-994-7054
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    Fax                  |    718-325-0798
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    N0042221
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    License Number State |    NY
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