Provider Demographics
NPI:1154529220
Name:DELLAVALLE, LINDSAY JOY (DO)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:JOY
Last Name:DELLAVALLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000 LB# 7550
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:925 US HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:NESHANIC STATION
Practice Address - State:NJ
Practice Address - Zip Code:08853
Practice Address - Country:US
Practice Address - Phone:908-788-9468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202345207Q00000X
NJ25MB09325200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine