Healthcare Provider Details

I. General information

NPI: 1740802776
Provider Name (Legal Business Name): ERIN DELGADO REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2399 N UNION STREET EXT
OLEAN NY
14760-1574
US

IV. Provider business mailing address

2399 N UNION STREET EXT
OLEAN NY
14760-1574
US

V. Phone/Fax

Practice location:
  • Phone: 716-375-4601
  • Fax: 716-375-5190
Mailing address:
  • Phone: 716-375-4601
  • Fax: 716-375-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number632569
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: