Individual
MR. PETER R DELLERBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
1676 SUNSET AVE, UTICA, NY 13502-5416
(315) 624-8110
(315) 624-8115
Mailing address
1676 SUNSET AVE, FAXTON 4TH FLOOR, UTICA, NY 13502-5416
(315) 624-8110
(315) 624-8115
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
300813
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01475956
—
NY
Enumeration date
10/17/2006
Last updated
04/26/2018
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