Provider Demographics
NPI:1528081320
Name:DELANEY, BRIAN (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:DELANEY
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:PO BOX 1032
Mailing Address - Street 2:THROGGS NECK STATION
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-0996
Mailing Address - Country:US
Mailing Address - Phone:718-364-6199
Mailing Address - Fax:718-364-6502
Practice Address - Street 1:2371 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-8113
Practice Address - Country:US
Practice Address - Phone:718-364-6199
Practice Address - Fax:718-364-6502
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158568207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3C2982OtherHEALTHNET
NYP426870OtherOXFORD
NM46691OtherAETNA.U.S.HEALTHCARE
NY0070963OtherGHI
NY01118405Medicaid
NY3C2982OtherHEALTHNET
NY0070963OtherGHI
NM46691OtherAETNA.U.S.HEALTHCARE