Provider Demographics
NPI:1144582552
Name:DELLAFERA, CIARAN A (MD)
Entity Type:Individual
Prefix:
First Name:CIARAN
Middle Name:A
Last Name:DELLAFERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:34 HAVERHILL ST
Mailing Address - Street 2:3RD FLOOR RESIDENCY
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2884
Mailing Address - Country:US
Mailing Address - Phone:978-686-0090
Mailing Address - Fax:978-687-2106
Practice Address - Street 1:34 HAVERHILL ST
Practice Address - Street 2:3RD FLOOR RESIDENCY
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2884
Practice Address - Country:US
Practice Address - Phone:978-686-0090
Practice Address - Fax:978-687-2106
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA252333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine