Provider Demographics
NPI:1689852295
Name:DELGADO, JAMES R (BSC, CMT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:DELGADO
Suffix:
Gender:M
Credentials:BSC, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2714
Mailing Address - Country:US
Mailing Address - Phone:610-327-3363
Mailing Address - Fax:
Practice Address - Street 1:1810 SWAMP PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9307
Practice Address - Country:US
Practice Address - Phone:610-327-3363
Practice Address - Fax:610-327-9829
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAMTA483174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist