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NPI Code Detail

MEDICARE: DINA ANN IACONE DO

MEDICARE: DINA ANN IACONE DO
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
1207Q00000XFamily Medicine PhysicianC2-0024450DE

General Provider Information

NPI Number : 1083292288
Entity Type Code : Individual
Provider Name (Legal Business Name) : DINA ANN IACONE DO
Provider Business Mailing Address
First Line : 3565 PHILADELPHIA PIKE
Second Line :
City : CLAYMONT
State : DE
Zip : 19703-3106
Country : US
Telephone Number : 302-320-4110
Fax Number : 302-798-6672
Provider Business Practice Location Address
First Line : 3565 PHILADELPHIA PIKE
Second Line :
City : CLAYMONT
State : DE
Zip : 19703-3106
Country : US
Telephone Number : 302-320-4110
Fax Number : 302-798-6672
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2021
Last Update Date : 06/25/2024

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