Individual
MRS. AMANDA MARIA DELCAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002616
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008036975
—
CT
01
—
1158906
USA
CT
01
—
26160
CONNECTICARE
CT
01
—
642587
WELLCARE
CT
01
—
9840786
AETNA
CT
01
—
P01268782
RR MEDICARE
CT
01
—
P4447933
OXFORD
CT
Enumeration date
10/17/2011
Last updated
11/09/2021
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