Provider Demographics
NPI:1124062344
Name:ALCID, FELOCELIA DELADISMA (MD)
Entity type:Individual
Prefix:DR
First Name:FELOCELIA
Middle Name:DELADISMA
Last Name:ALCID
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 1:38 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2326
Mailing Address - Country:US
Mailing Address - Phone:201-447-0785
Mailing Address - Fax:
Practice Address - Street 1:W.38 GLEN AVENUE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2324
Practice Address - Country:US
Practice Address - Phone:201-447-0785
Practice Address - Fax:973-890-4574
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02464300208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
001638B1JOtherMEDICAL BILLING NUMBER
NJ2840502Medicaid
NJG59183Medicare UPIN