Provider Demographics
NPI:1588962955
Name:DEFELICE, PAUL ALBERT (PHARMACIST)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ALBERT
Last Name:DEFELICE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RAPHAEL RD
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-2209
Mailing Address - Country:US
Mailing Address - Phone:302-235-7123
Mailing Address - Fax:
Practice Address - Street 1:4 POLLY DRUMMOND SHPG CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-4859
Practice Address - Country:US
Practice Address - Phone:302-731-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist