Delisi, Michael David

Delisi, Michael David is an individual health care provider with primary practice located at 1135 Broad St St. Joseph'S Family Medicine At Clifton, Clifton NJ 07013-3346. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Delisi, Michael David can be contacted via phone (973) 754-4100.

Contact Information

Primary practice address
1135 Broad St St. Joseph'S Family Medicine At Clifton Clifton NJ 07013-3346
Phone: (973) 754-4100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25MA05259000 New Jersey

Profile Details

NPI number 1275575110
LBN Legal business name Delisi, Michael David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Nov 15th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275575110 NPPES
New Jersey MEDICAID 4136403
New Jersey MEDICAID 1968009

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