Provider Demographics
NPI:1902052053
Name:DELVECCHIO, CARMELA (OTR/L)
Entity type:Individual
Prefix:
First Name:CARMELA
Middle Name:
Last Name:DELVECCHIO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9624 BLINCOE CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3108
Mailing Address - Country:US
Mailing Address - Phone:703-798-0710
Mailing Address - Fax:
Practice Address - Street 1:9624 BLINCOE CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3108
Practice Address - Country:US
Practice Address - Phone:703-798-0710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003348225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2550OtherCAREFIRST BLUE CROSS BLUE SHIELD