Provider Demographics
NPI:1629122130
Name:PRELI, OLINDO JOSEPH (MD)
Entity Type:Individual
Prefix:MR
First Name:OLINDO
Middle Name:JOSEPH
Last Name:PRELI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32917 NASSAU COURT SOUTH
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-853-5864
Mailing Address - Fax:
Practice Address - Street 1:32917 NASSAU COURT SOUTH
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-853-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009487E207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
231953210OtherTAX ID
000000072597Other3 RIVERS
PA0704788Medicaid
PA000002835OtherBCBS
243792OtherHEALTH NET
PW053773Other1ST PRIORITY
PA065463OtherAETNA
B29881Medicare UPIN
000000072597Other3 RIVERS