Provider Demographics
NPI:1831220482
Name:DELGADO, DANIELLE VIVIENNE (LPN)
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:VIVIENNE
Last Name:DELGADO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GREENLAWN RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-3312
Mailing Address - Country:US
Mailing Address - Phone:914-656-6050
Mailing Address - Fax:
Practice Address - Street 1:4 GREENLAWN RD
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-3312
Practice Address - Country:US
Practice Address - Phone:914-656-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249526-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01715219Medicaid