Provider Demographics
NPI:1902910821
Name:DELPRETE, DEANNA M (DO)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:DELPRETE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 MAIN AVE
Mailing Address - Street 2:SUITE100
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1080
Mailing Address - Country:US
Mailing Address - Phone:203-644-1100
Mailing Address - Fax:203-644-1111
Practice Address - Street 1:761 MAIN AVE
Practice Address - Street 2:SUITE100
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-644-1100
Practice Address - Fax:203-644-1111
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000367207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001003673Medicaid
E04425Medicare UPIN
CT160001737Medicare ID - Type Unspecified