DENISE M. BROLL-DALTON (NPI# 1508053554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508053554 |
| Entity Type | Individual |
| Full Name | DENISE M. BROLL-DALTON |
| Credential | PA-C |
| Practice Address |
1 Crescent Dr Suite 100 Philadelphia PA 19112-1015 |
| Mailing Address |
2301 S Broad St Suite 100 Philadelphia PA 19148-3542 |
| Practice Telephone | 2159529900 |
| Practice Fax Number | 2159529977 |
| Mailing Telephone | 2159529900 |
| Mailing Fax Number | 2159529977 |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2016-03-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA001026L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 CRESCENT DR SUITE 100 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19112-1015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174502157 | Francis S Matarazzo | Dentist | 1 Crescent Dr, Suite 300, Philadelphia, PA 19112-1015 | 2006-01-10 |
| 1912440405 | Francis S Matarazzo Dds PC | Dentist | 1 Crescent Dr, Ste 300, Philadelphia, PA 19112-1015 | 2016-12-01 |
| 1033374491 | Rachel Dickinson | Physician Assistant | 1 Crescent Dr, Suite 100, Philadelphia, PA 19112-1015 | 2008-07-25 |
| 1255539896 | Sheldon Gottlieb | Physical Medicine & Rehabilitation | 1 Crescent Dr, Suite 100, Philadelphia, PA 19112 | 2007-07-05 |
| 1508080813 | Anita Marie Milici | Dentist | 1 Crescent Dr, Suite 300, Philadelphia, PA 19112-1015 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265950802 | M&m Surgical Center PC | Clinic/Center | 1 Crescent Dr. Suite 300, Philadelphia, PA 19112 | 2017-09-05 |
| 1710114293 | Riverview Surgery Center At The Navy Yard Lp | Clinic/Center | Three Crescent Drive, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2009-06-11 |
| 1023136942 | Susan Elizabeth Fredericks | Physician Assistant | 1 Crescent Drive Suite 100, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2007-03-27 |
| 1023132867 | Healthmark, Incorporated | Clinic/Center | 1 Crescent Dr., Navy Yard Suite 100, Philadelphia, PA 19112 | 2007-03-19 |
| 1932526258 | Anne Catherine Kane | Otolaryngology | 3 Crescent Dr, Philadelphia, PA 19112 | 2014-03-25 |
| 1407074750 | Jennifer L Johansen | Pharmacist | 5 Crescent Dr, Ny0200, Philadelphia, PA 19112-1001 | 2007-04-23 |
| 1679981708 | Andrew Trofa | Internal Medicine | 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 | 2014-08-01 |
| 1508029463 | Robert Williams Carr | Preventive Medicine | 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 | 2008-07-09 |
| 1952947152 | Navy Yard Dental Associates, Pllc | Dentist | 1 Crescent Dr Ste 300, Philadelphia, PA 19112-1015 | 2019-11-22 |
| 1063067635 | Jefferson University Radiology Associates, LLC | Radiology | 3 Crescent Dr Ste 1002, Philadelphia, PA 19112-1016 | 2019-08-09 |
| Find all providers in zip 19112 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051763 | Molly Catherine Peters | Physician Assistant | 4338 Boone St, Philadelphia, PA 19128-4901 | 2020-10-19 |
| 1356951024 | Murielle M Boursiquot | Physician Assistant | 7901 Henry Ave Apt G302, Philadelphia, PA 19128-3072 | 2020-08-06 |
| 1134757156 | Julie Hutchison | Physician Assistant | 2922 N 5th St, Philadelphia, PA 19133-2801 | 2020-03-27 |
| 1174155857 | Rebecca Volpe | Physician Assistant | 738 Longshore Ave, Philadelphia, PA 19111-4325 | 2020-02-10 |
| 1306308879 | Ria Raju | Physician Assistant | 7909 Lawndale Ave, Philadelphia, PA 19111-2652 | 2019-04-03 |
| 1386101400 | Ashley Thomas | Physician Assistant | 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 | 2019-02-25 |
| 1487119186 | Shelby Elizabeth Ginsburg | Physician Assistant | 1200 W Tabor Rd Fl Bl4, Philadelphia, PA 19141-3019 | 2019-02-06 |
| 1346720059 | Noelle Elizabeth Mullanaphy | Physician Assistant | 4031 Sheffield St, Philadelphia, PA 19136-3101 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| 1912409533 | Lauren Joy Barton | Physician Assistant | 5401 N Broad St Ste 363, Philadelphia, PA 19141 | 2018-02-28 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19112 |
Please comment or provide details below to improve the information on DENISE M. BROLL-DALTON.
| 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.