Provider Demographics
NPI:1144362435
Name:DALMASI, ODEIDA DE LOS A (MD)
Entity type:Individual
Prefix:DR
First Name:ODEIDA
Middle Name:DE LOS A
Last Name:DALMASI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1333
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08105-0333
Mailing Address - Country:US
Mailing Address - Phone:856-963-4766
Mailing Address - Fax:
Practice Address - Street 1:700 ARCH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-1505
Practice Address - Country:US
Practice Address - Phone:215-521-4092
Practice Address - Fax:215-521-4083
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine