Provider Demographics
NPI:1457468472
Name:DELFIN, PAUL E (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:DELFIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 RIDGEWOOD RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1189
Mailing Address - Country:US
Mailing Address - Phone:610-378-9601
Mailing Address - Fax:610-378-9061
Practice Address - Street 1:2201 RIDGEWOOD RD
Practice Address - Street 2:SUITE 400
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1189
Practice Address - Country:US
Practice Address - Phone:610-378-9601
Practice Address - Fax:610-378-9061
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003396L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA95536Medicare PIN
PARO6043Medicare UPIN
PA095536XTGMedicare PIN