Provider Demographics
NPI:1639192800
Name:DELGAIZO, ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:DELGAIZO
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 1:36 NEWARK AVENUE
Mailing Address - Street 2:SUITE 200 UROLOGY CONSULTANTS PA
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-4121
Mailing Address - Country:US
Mailing Address - Phone:973-759-6950
Mailing Address - Fax:973-759-6945
Practice Address - Street 1:36 NEWARK AVENUE
Practice Address - Street 2:SUITE 200 UROLOGY CONSULTANTS PA
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-4121
Practice Address - Country:US
Practice Address - Phone:973-759-6950
Practice Address - Fax:973-759-6945
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02050900208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1851403Medicaid
NJ571119A86Medicare ID - Type Unspecified
C59963Medicare UPIN