Provider Demographics
NPI:1114086642
Name:HEARD, DELANO R (DO)
Entity Type:Individual
Prefix:DR
First Name:DELANO
Middle Name:R
Last Name:HEARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 CHESTNUT STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1834
Mailing Address - Country:US
Mailing Address - Phone:856-779-0111
Mailing Address - Fax:856-779-0936
Practice Address - Street 1:111 CHESTNUT STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-1834
Practice Address - Country:US
Practice Address - Phone:856-779-0111
Practice Address - Fax:856-779-0936
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB025870002084P0800X
PAOS002911L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
02878710285OtherAMA ID
02878710285OtherAMA ID
B33662Medicare UPIN