Provider Demographics
NPI:1740784651
Name:DELLE DONNA, PAUL GEORGE
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:GEORGE
Last Name:DELLE DONNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 EDGEWATER AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-2431
Mailing Address - Country:US
Mailing Address - Phone:201-832-7131
Mailing Address - Fax:
Practice Address - Street 1:900 EDGEWATER AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-2431
Practice Address - Country:US
Practice Address - Phone:201-832-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program