Provider Demographics
NPI:1447222443
Name:DELEO, MICHAEL J JR (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:DELEO
Suffix:JR
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:PO BOX 416402
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6402
Mailing Address - Country:US
Mailing Address - Phone:413-443-6000
Mailing Address - Fax:413-442-2260
Practice Address - Street 1:BERKSHIRE HEMATOLOGY ONCOLOGY
Practice Address - Street 2:8 CONTE DR
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-443-6000
Practice Address - Fax:413-442-2260
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA47960207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ01136Medicare ID - Type Unspecified
MAB74143Medicare UPIN