MEDICARE: JENNY DELALEU RN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F334623	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437284551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY DELALEU RN, FNP-BC

Provider Business Mailing Address
First Line	:	294 W MERRICK RD STE 1
Second Line	:
City	:	FREEPORT
State	:	NY
Zip	:	11520-3357
Country	:	US
Telephone Number	:	516-279-5484
Fax Number	:	516-589-7569

Provider Business Practice Location Address
First Line	:	294 W MERRICK RD STE 1
Second Line	:
City	:	FREEPORT
State	:	NY
Zip	:	11520-3357
Country	:	US
Telephone Number	:	516-279-5484
Fax Number	:	516-589-7569

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	05/31/2024

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