Delisfort, Guy J
Delisfort, Guy J is an individual health care provider with primary practice located at 815 S 12Th St , Newark NJ 07108-1307. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Delisfort, Guy J can be contacted via phone (973) 375-4479.Contact Information
Primary practice address
815 S 12Th St
Newark NJ 07108-1307
Phone: (973) 375-4479
Fax: (973) 375-3697
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 25MA02477100 | New Jersey |
Profile Details
NPI number | 1407803539 |
---|---|
LBN Legal business name | Delisfort, Guy J |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 27th, 2006 |
Last updated | Jun 10th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407803539 | NPPES |
New Jersey | MEDICAID | 3611701 |
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