Basic Information
Provider Information
NPI: 1144311416
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONSOLINI
FirstName: DEBORAH
MiddleName: M.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 191
Address2: PROVIDER ENROLLMENT DEPT
City: ROCKLAND
State: DE
PostalCode: 197320191
CountryCode: US
TelephoneNumber: 3026516212
FaxNumber: 3026514945
Practice Location
Address1: A.I. DUPONT HOSPITAL FOR CHILDREN
Address2: 1600 ROCKLAND ROAD
City: WILMINGTON
State: DE
PostalCode: 198033607
CountryCode: US
TelephoneNumber: 3026514000
FaxNumber: 3026514945
Other Information
ProviderEnumerationDate: 09/28/2006
LastUpdateDate: 09/09/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XC10005976DEN Allopathic & Osteopathic PhysiciansPediatrics 
208D00000XC10005976DEY Allopathic & Osteopathic PhysiciansGeneral Practice 
208M00000XC10005976DEN Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
752710105NJ MEDICAID
345610205MD MEDICAID
Q0597705SC MEDICAID
00162878905PA MEDICAID


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