Provider Demographics
NPI:1225386287
Name:DELAO, ROBERT P (RT (R))
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:P
Last Name:DELAO
Suffix:
Gender:M
Credentials:RT (R)
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 EUBANK BLVD SE
Mailing Address - Street 2:BLD. 831/832
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-3453
Mailing Address - Country:US
Mailing Address - Phone:505-844-4237
Mailing Address - Fax:
Practice Address - Street 1:1515 EUBANK BLVD SE
Practice Address - Street 2:BLD. 831/832
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-3453
Practice Address - Country:US
Practice Address - Phone:505-844-4237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-24
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM009192471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography