Organization Name: | HENRY G DELATORRE MD PC |
NPI Number: | 1679997076 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HENRY G DELATORRE (OWNER) |
Mailing Address: | 90 Beaver Drive 214d, Bldg D Dubois |
State: | PA US |
Postal Code: | 15801 |
Phone Number: | 8668139862 |
Fax Number: | |
NPI Enumeration Date: | 02/06/2014 |
NPI Last Update Date: | 02/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |