MR. HORACE MICHAEL DELISSER JR. (NPI# 1306357256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306357256 |
| Entity Type | Individual |
| Full Name | MR. HORACE MICHAEL DELISSER JR. |
| Credential | PAC |
| Practice Address |
150 Delsea Dr Ste B Sewell NJ 08080-9478 |
| Practice Telephone | 8563020500 |
| Practice Fax Number | 8563020504 |
| Mailing Telephone | 8563020500 |
| Mailing Fax Number | 8563020504 |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2019-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
25MP00494800 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
MA059415 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 479 Thomas Jones Way Ste 300, Exton, PA 193412552 | 6102809999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578577094 | Horace M Delisser | Internal Medicine | 3400 Spruce Street, 3 Ravdin Building, Suite F, Philadelphia, PA 19104-4206 | 2006-07-28 |
| Street Address |
150 DELSEA DR STE B |
| City | SEWELL |
| State | NJ |
| Zip Code | 08080-9478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467726364 | Jennifer Rebecca Lincoln | Physician Assistant | 150 Delsea Dr Ste B, Sewell, NJ 08080-9478 | 2012-02-24 |
| 1861049777 | Julia Nicole Ashe | Physician Assistant | 150 Delsea Dr Ste B, Sewell, NJ 08080-9478 | 2019-08-26 |
| 1821576661 | Sarah A Kelly | Physician Assistant | 150 Delsea Dr Ste B, Sewell, NJ 08080-9478 | 2018-08-03 |
| 1508244898 | Randolph Sanchez | Internal Medicine | 150 Delsea Dr Ste B, Sewell, NJ 08080-9478 | 2015-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679180301 | Peter Ansong | Pharmacist | 500 Egg Harbor Road, Sewell, NJ 08080 | 2020-09-27 |
| 1477018752 | Shi-iii Washington Township LLC | Alzheimer Center (Dementia Center) | 339 Greentree Road, Washington Township, NJ 08080 | 2019-01-31 |
| 1245741495 | Assoc. for Retarded Citizens. Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Fawn Drive, Sewell, NJ 08080 | 2017-10-16 |
| 1851802029 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 275 Greentree Road, Sewell, NJ 08080 | 2017-10-16 |
| 1598284770 | Bryan Hendricks | Psychologist | 123 Egg Harbor Rd., Suite 302, Sewell, NJ 08080 | 2017-09-19 |
| 1912426339 | Mary Faralli | Speech-Language Pathologist | 24 Upton Way, Sewell, NJ 08080 | 2017-09-18 |
| 1669990578 | Oaks Integrated Care | Clinic/Center | 322 Fishpond Rd, Sewell, NJ 08080 | 2017-08-31 |
| 1972032316 | Nutan K Ravani | Social Worker | 3 Heritage Valley Drive, Sewell, NJ 08080 | 2017-06-08 |
| 1447784038 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 224 West Warren Avenue, Sewell, NJ 08080 | 2017-04-20 |
| 1326572173 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 363 Ganttown Road, Turnersville, NJ 08080 | 2017-04-19 |
| Find all providers in zip 08080 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609315720 | Kirill Levin | Physician Assistant | 570 Egg Harbor Rd Ste B1, Sewell, NJ 08080 | 2017-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062463 | Erica Josephine Lobuglio | Physician Assistant | 733 N Beers St Ste U3, Holmdel, NJ 07733-1513 | 2020-08-04 |
| 1407471493 | Angelice Grasso | Physician Assistant | 3 Holly Ln, Garfield, NJ 07026-3565 | 2020-06-15 |
| 1063036358 | Jaina Marie Lumkong | Physician Assistant | 905 Allwood Rd Ste 204, Clifton, NJ 07012-1946 | 2020-06-02 |
| 1740804384 | Allison Sy Tan | Physician Assistant | 10 Bahr Cir, Verona, NJ 07044-3200 | 2020-05-29 |
| 1114560851 | Brian Paul Leonhardt | Physician Assistant | 1113 Hospital Drive Professional Building East, Suite 100, Willingboro, NJ 08046 | 2019-10-25 |
| 1740830413 | Atara Hagler | Physician Assistant | 1500 Pleasant Valley Way Ste 101, West Orange, NJ 07052-2956 | 2019-09-16 |
| 1568943058 | Ekaterina M Rezvin | Physician Assistant | 80 Woodland Park Dr, Tenafly, NJ 07670-3028 | 2018-08-23 |
| 1225550353 | Kristen Cordiello | Physician Assistant | 1610 Route 88 Ste 203, Brick, NJ 08724-3018 | 2017-07-11 |
| 1710408232 | Angela Marie Freedman | Physician Assistant | 1 Riverview Plaza Multi Disciplinary Cancer Center, Red Bank, NJ 07701 | 2017-07-06 |
| 1063932259 | Matthew Gabriel | Physician Assistant | 25 Prospect Avernue, 2nd Floor, Hackensack, NJ 07601 | 2017-06-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.