Healthcare Provider Details

I. General information

NPI: 1497804827
Provider Name (Legal Business Name): FREDERIQUE P. DELHAYE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 E HIGHWAY 90 STE 200
SIERRA VISTA AZ
85635-9113
US

IV. Provider business mailing address

11670 N 109TH ST
SCOTTSDALE AZ
85259-3024
US

V. Phone/Fax

Practice location:
  • Phone: 520-263-3500
  • Fax:
Mailing address:
  • Phone: 732-221-6874
  • Fax: 928-233-8508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberFD5569770
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: