Individual
OPAL M DELISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-C
Contact information
Practice address
3 COOPER PLZ, SUITE 311, CAMDEN, NJ 08103-1438
(856) 342-2034
(856) 342-6608
Mailing address
1 FEDERAL ST, STE SW200, CAMDEN, NJ 08103-1155
(856) 342-2604
(856) 968-8282
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NR07295200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NR07295200
NJ MEDICAL LICENSE
NJ
Enumeration date
08/27/2007
Last updated
04/26/2016
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