Provider Demographics
NPI:1982602603
Name:DILELLO, PAMELA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LOUISE
Last Name:DILELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1141
Mailing Address - Country:US
Mailing Address - Phone:718-352-5772
Mailing Address - Fax:718-565-5120
Practice Address - Street 1:8321 57TH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4707
Practice Address - Country:US
Practice Address - Phone:718-429-1373
Practice Address - Fax:718-565-5120
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162850208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics