Individual
GUY J DELISFORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
815 S 12TH ST, NEWARK, NJ 07108-1307
(973) 375-4479
(973) 375-3697
Mailing address
815 S 12TH ST, NEWARK, NJ 07108-1307
(973) 375-4479
(973) 375-3697
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA02477100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3611701
—
NJ
Enumeration date
05/27/2006
Last updated
06/10/2008
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