Individual
MS. DOREEN DELANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1110 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-2048
(631) 476-9100
(631) 476-4919
Mailing address
1110 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-2048
(631) 476-9100
(631) 476-4919
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0062761
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05749940
—
NY
Enumeration date
07/17/2006
Last updated
05/28/2021
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