Provider Demographics
NPI:1487739371
Name:DELSORDO, DORA (APN, C)
Entity type:Individual
Prefix:
First Name:DORA
Middle Name:
Last Name:DELSORDO
Suffix:
Gender:F
Credentials:APN, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WHITE MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1600
Mailing Address - Country:US
Mailing Address - Phone:908-371-1152
Mailing Address - Fax:
Practice Address - Street 1:195 LITTLE ALBANY ST
Practice Address - Street 2:CANCER INSTITUTE OF NJ - PEDIATRIC HEME/ONC
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-235-8498
Practice Address - Fax:732-235-6462
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO11260600364SX0204X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SX0204XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology, Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7829001Medicaid
NJ096171C6CMedicare PIN
Q57278Medicare UPIN
NJ206243ADXMedicare PIN