Provider Demographics
NPI:1851734669
Name:DELICE, ANAEL DESTIN JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ANAEL
Middle Name:DESTIN
Last Name:DELICE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:761 S HARDING HWY
Mailing Address - Street 2:
Mailing Address - City:BUENA
Mailing Address - State:NJ
Mailing Address - Zip Code:08310-9732
Mailing Address - Country:US
Mailing Address - Phone:856-697-0111
Mailing Address - Fax:856-697-0003
Practice Address - Street 1:761 S HARDING HWY
Practice Address - Street 2:
Practice Address - City:BUENA
Practice Address - State:NJ
Practice Address - Zip Code:08310-9732
Practice Address - Country:US
Practice Address - Phone:856-697-0001
Practice Address - Fax:856-697-0003
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09347400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine