Basic Information
| Provider Information | |||||||||
| NPI: | 1750616371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELP | ||||||||
| FirstName: | PRISCILLA | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 145 HOSPITAL AVE | ||||||||
| Address2: | SUITE 315 | ||||||||
| City: | DU BOIS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 158011462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143716172 | ||||||||
| FaxNumber: | 8143713921 | ||||||||
| Practice Location | |||||||||
| Address1: | 145 HOSPITAL AVE | ||||||||
| Address2: | SUITE 315 | ||||||||
| City: | DU BOIS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 158011462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143716172 | ||||||||
| FaxNumber: | 8143713921 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2009 | ||||||||
| LastUpdateDate: | 06/20/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA056174 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.