Provider Demographics
NPI:1467471839
Name:DELGATTO, LOUIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:DELGATTO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 DOWNING DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-1428
Mailing Address - Country:US
Mailing Address - Phone:570-675-0969
Mailing Address - Fax:570-674-5244
Practice Address - Street 1:827 OLEY VALLEY RD
Practice Address - Street 2:
Practice Address - City:WHITE HAVEN
Practice Address - State:PA
Practice Address - Zip Code:18661-3043
Practice Address - Country:US
Practice Address - Phone:570-443-4037
Practice Address - Fax:570-443-4052
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD025632E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA414642HZYMedicare PIN
PAF34051Medicare UPIN