MEDICARE: JAMES DALZELL 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	2085R0001X	Radiation Oncology Physician	25MA05776800	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	073854	OTHER	NJ	MEDICARE PROVIDER TRANSACTION ACCESS NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	4654852	OTHER	NJ	AETNA - TRADITIONAL
3	0157757000	OTHER	NJ	AMERIHEALTH
4	2231822	OTHER	NJ	USHC
5	223424577	OTHER	NJ	CIGNA
6	1169660	OTHER	NJ	HORIZON MERCY
7	1884846	OTHER	NJ	AETNA - HMO
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	0157757000	OTHER	PA	IBC/KHPE
10	P2043548	OTHER	NJ	OXFORD

General Provider Information

NPI Number	:	1417997719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DALZELL MD

Provider Business Mailing Address
First Line	:	411 NEW RD
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1648
Country	:	US
Telephone Number	:	609-383-6033
Fax Number	:	609-383-1548

Provider Business Practice Location Address
First Line	:	801 NEW RD
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1610
Country	:	US
Telephone Number	:	609-407-5055
Fax Number	:	609-407-5056

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	12/01/2008

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Directions to “ JAMES DALZELL MD” Practice Location

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