Individual
DR. DIANE M. DEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 S 11TH ST, SUITE 3390, PHILADELPHIA, PA 19107-4824
(215) 955-6226
(215) 923-1562
Mailing address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD047440L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001299161
—
PA
05
—
6376801
—
NJ
Enumeration date
07/13/2006
Last updated
03/10/2014
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