Healthcare Provider Details

I. General information

NPI: 1770084931
Provider Name (Legal Business Name): KAREN DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 N GOODMAN ST
ROCHESTER NY
14607-1185
US

IV. Provider business mailing address

320 N GOODMAN ST
ROCHESTER NY
14607-1185
US

V. Phone/Fax

Practice location:
  • Phone: 585-325-3145
  • Fax: 585-325-3188
Mailing address:
  • Phone: 585-325-3145
  • Fax: 585-325-3188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberNYCPS-1459
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: