Provider Demographics
NPI:1902543184
Name:DELVALLE, ALEX
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:DELVALLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 KINGSDOWN CT
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-1830
Mailing Address - Country:US
Mailing Address - Phone:484-432-3708
Mailing Address - Fax:
Practice Address - Street 1:117 S CHESTER RD STE 101
Practice Address - Street 2:
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-1921
Practice Address - Country:US
Practice Address - Phone:215-947-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03864237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist