Provider Demographics
NPI:1477690949
Name:VILLECCO, DANTE JOSEPH (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DANTE
Middle Name:JOSEPH
Last Name:VILLECCO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 STONEY RUN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2036
Mailing Address - Country:US
Mailing Address - Phone:619-808-3578
Mailing Address - Fax:
Practice Address - Street 1:2 READS WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1607
Practice Address - Country:US
Practice Address - Phone:302-709-4547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL6-0A00616367500000X
DEL1-0040525163W00000X
SC71167163W00000X
FL9308294367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse