Healthcare Provider Details

I. General information

NPI: 1811851231
Provider Name (Legal Business Name): ROBERT DELANEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W 53RD ST APT 2I
NEW YORK NY
10019-5142
US

IV. Provider business mailing address

540 W 53RD ST APT 2I
NEW YORK NY
10019-5142
US

V. Phone/Fax

Practice location:
  • Phone: 917-292-1104
  • Fax:
Mailing address:
  • Phone: 917-292-1104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number312609
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: