Provider Demographics
NPI:1356645428
Name:DILEO, RENEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:DILEO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 E LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2407
Mailing Address - Country:US
Mailing Address - Phone:610-466-9250
Mailing Address - Fax:610-466-9254
Practice Address - Street 1:1825 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-2407
Practice Address - Country:US
Practice Address - Phone:610-466-9250
Practice Address - Fax:610-466-9254
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002073L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical