Provider Demographics
NPI:1174015572
Name:DELCORE, PHILIP RICHARD JR (RRT)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:RICHARD
Last Name:DELCORE
Suffix:JR
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2824
Mailing Address - Country:US
Mailing Address - Phone:781-924-5122
Mailing Address - Fax:
Practice Address - Street 1:226 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-2824
Practice Address - Country:US
Practice Address - Phone:781-924-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RT3567227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty