Provider Demographics
NPI:1750585709
Name:DELVALLE, YISSELL (MD)
Entity type:Individual
Prefix:
First Name:YISSELL
Middle Name:
Last Name:DELVALLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6000 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1420
Mailing Address - Country:US
Mailing Address - Phone:201-864-4897
Mailing Address - Fax:201-460-0913
Practice Address - Street 1:14 N DEAN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2807
Practice Address - Country:US
Practice Address - Phone:917-345-4273
Practice Address - Fax:201-460-0913
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA082107002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry