Provider Demographics
NPI:1942984018
Name:DELGADILLO, RAQUEL (PA-C)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:DELGADILLO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PORTER ST
Mailing Address - Street 2:
Mailing Address - City:QUAKER HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06375-1514
Mailing Address - Country:US
Mailing Address - Phone:860-501-4898
Mailing Address - Fax:
Practice Address - Street 1:8 PORTER ST
Practice Address - Street 2:
Practice Address - City:QUAKER HILL
Practice Address - State:CT
Practice Address - Zip Code:06375-1514
Practice Address - Country:US
Practice Address - Phone:860-501-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant