Provider Demographics
NPI:1376625236
Name:DELZER, ROBERT JAMES (IDC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:DELZER
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 COMMERCIAL ST.
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109
Mailing Address - Country:US
Mailing Address - Phone:617-223-3121
Mailing Address - Fax:617-223-3038
Practice Address - Street 1:427 COMMERCIAL ST.
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109
Practice Address - Country:US
Practice Address - Phone:617-223-3121
Practice Address - Fax:617-223-3038
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other