Provider Demographics
NPI:1730514407
Name:DELANCEY, DANA MARIE (DC, MS)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:DELANCEY
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9631 HITCHCOCK POINT RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:13030-9663
Mailing Address - Country:US
Mailing Address - Phone:518-321-4758
Mailing Address - Fax:
Practice Address - Street 1:9631 HITCHCOCK POINT RD
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:NY
Practice Address - Zip Code:13030-9663
Practice Address - Country:US
Practice Address - Phone:518-321-4758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012413111NI0900X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0900XChiropractic ProvidersChiropractorInternist