Provider Demographics
NPI:1235175712
Name:DALOPE, MANUEL GARCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:GARCIA
Last Name:DALOPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2504
Mailing Address - Country:US
Mailing Address - Phone:315-329-7520
Mailing Address - Fax:
Practice Address - Street 1:815 JAMES ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2504
Practice Address - Country:US
Practice Address - Phone:315-329-7520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124392-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00462217Medicaid
38586AMedicare PIN
NYB82100Medicare UPIN