Provider Demographics
NPI:1609163484
Name:SLAKOPER DELESSIO, JACQUELINE HELENE (DO)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:HELENE
Last Name:SLAKOPER DELESSIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:301 OXFORD VALLEY RD STE 1501
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7706
Mailing Address - Country:US
Mailing Address - Phone:215-826-3022
Mailing Address - Fax:215-698-3730
Practice Address - Street 1:301 OXFORD VALLEY RD STE 1501
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7706
Practice Address - Country:US
Practice Address - Phone:215-826-3022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS016359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA332859Medicare PIN