Healthcare Provider Details

I. General information

NPI: 1386593945
Provider Name (Legal Business Name): JESSICA LYNN DELTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL RD
PATCHOGUE NY
11772-4870
US

IV. Provider business mailing address

20 RAYMOND RD
EAST HAMPTON CT
06424-1338
US

V. Phone/Fax

Practice location:
  • Phone: 631-654-7100
  • Fax:
Mailing address:
  • Phone: 860-368-9596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: