MEDICARE: HERNAN DEL ARCA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	25MA07476400	NJ
2	2085R0202X	Diagnostic Radiology Physician	231705	NY
3	2085R0202X	Diagnostic Radiology Physician	ME123273	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073500518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERNAN DEL ARCA MD

Provider Business Mailing Address
First Line	:	57 ROSEDALE AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3411
Country	:	US
Telephone Number	:	201-854-5114
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 RIVER RD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-6217
Country	:	US
Telephone Number	:	201-854-5109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	04/12/2022

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