Healthcare Provider Details

I. General information

NPI: 1326971839
Provider Name (Legal Business Name): DELANEY O'CONNOR MS, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 W LAKE AVE
BALTIMORE MD
21210-1298
US

IV. Provider business mailing address

236 RODGERS FORGE RD APT C
BALTIMORE MD
21212-1339
US

V. Phone/Fax

Practice location:
  • Phone: 252-367-9180
  • Fax:
Mailing address:
  • Phone: 252-367-9180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: