Provider Demographics
NPI:1346342375
Name:DELP, DENNIS R (OD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:R
Last Name:DELP
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-1510
Mailing Address - Country:US
Mailing Address - Phone:717-764-4231
Mailing Address - Fax:717-767-1917
Practice Address - Street 1:1954 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-1510
Practice Address - Country:US
Practice Address - Phone:717-764-4231
Practice Address - Fax:717-767-1917
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000638152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50002533OtherCAPITAL BLUE CROSS
PA005486380001Medicaid
PA171153OtherBLUE SHIELD
PA50002533OtherCAPITAL BLUE CROSS
PA097167Medicare PIN