Provider Demographics
NPI:1619998622
Name:THOMAS A. DILIBERTO, D.O.
Entity Type:Organization
Organization Name:THOMAS A. DILIBERTO, D.O.
Other - Org Name:DELCO RADIOLOGIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:DILIBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-284-8300
Mailing Address - Street 1:PO BOX 7780-1760
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0001
Mailing Address - Country:US
Mailing Address - Phone:610-734-0630
Mailing Address - Fax:610-734-0874
Practice Address - Street 1:501 N LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1114
Practice Address - Country:US
Practice Address - Phone:610-284-8300
Practice Address - Fax:610-284-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA073474Medicare PIN