Individual
ANDREA DELLAVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
33-57 HARRISON ST, HOSPITALIST DEPT, JOHNSON CITY, NY 13790-2107
(607) 763-6622
(607) 763-5064
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2580
(607) 729-8156
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
267818
NY
208M00000X
Hospitalist Physician
Primary
267818
NY
390200000X
Student in an Organized Health Care Education/Training Program
OT013071
PA
Other
Enumeration date
05/12/2009
Last updated
12/12/2012
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