Provider Demographics
NPI:1518714252
Name:DELAO-PORTELL, PAULINA
Entity type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:DELAO-PORTELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 WAYNE ST APT 202
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3490
Mailing Address - Country:US
Mailing Address - Phone:917-573-7006
Mailing Address - Fax:
Practice Address - Street 1:167 WAYNE ST APT 202
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3490
Practice Address - Country:US
Practice Address - Phone:917-573-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist