Basic Information
| Provider Information | |||||||||
| NPI: | 1336487503 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | C A DILALLO MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9658 WASHINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207231870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014521256 | ||||||||
| FaxNumber: | 4432742391 | ||||||||
| Practice Location | |||||||||
| Address1: | 7500 GREENWAY CENTER DR | ||||||||
| Address2: | 520 | ||||||||
| City: | GREENBELT | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207703502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012202127 | ||||||||
| FaxNumber: | 4432742391 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2013 | ||||||||
| LastUpdateDate: | 05/02/2016 | ||||||||
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| AuthorizedOfficialLastName: | DILALLO | ||||||||
| AuthorizedOfficialFirstName: | CHESTER | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3014521256 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | D10535 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.