Individual
JOSEPH DELLAVALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
59 PAGE HILL RD, BERLIN, NH 03570-3531
(603) 752-2200
(603) 326-5832
Mailing address
59 PAGE HILL RD, BERLIN, NH 03570-3531
(603) 752-2200
(603) 326-5832
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MI43083768
MI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
15057
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0829560001
MEDICARE DME
MI
01
—
0C16002
MEDICARE GROUP
MI
05
—
104652714
—
MI
01
—
JD083768
BLUECROSS STATE ID
MI
Enumeration date
06/07/2006
Last updated
01/17/2014
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