Individual
MARIE ELCY DELOACHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1165 E 54TH ST APT 6O, BROOKLYN, NY 11234-2430
(718) 690-6509
Mailing address
1165 E 54TH ST APT 6O, BROOKLYN, NY 11234-2430
(718) 690-6509
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1292901
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0675460013
HSPO
PA
Enumeration date
01/29/2019
Last updated
01/29/2019
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