Healthcare Provider Details

I. General information

NPI: 1720053788
Provider Name (Legal Business Name): DELMA YEMISI JARRETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST RM F631
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST RM F631
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-6936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number307977-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number307977
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: