Healthcare Provider Details

I. General information

NPI: 1801049614
Provider Name (Legal Business Name): KAREN ROSE DELGADO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 CARROLL ST
BROOKLYN NY
11215-1118
US

IV. Provider business mailing address

618 CARROLL ST
BROOKLYN NY
11215-1118
US

V. Phone/Fax

Practice location:
  • Phone: 917-407-3241
  • Fax:
Mailing address:
  • Phone: 917-407-3241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number007491
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: