Provider Demographics
NPI:1548455314
Name:DELGIORNO, CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:DELGIORNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:239 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:STE 370
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-4001
Practice Address - Country:US
Practice Address - Phone:856-728-3636
Practice Address - Fax:856-728-3633
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99112207R00000X
NJ25MA08562500207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279722400Medicaid
NJ0208680Medicaid
FLAJ062ZMedicare PIN
NJ0208680Medicaid