Healthcare Provider Details

I. General information

NPI: 1801835616
Provider Name (Legal Business Name): ANDREW J DELANEY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3326 MAIN ST
BIRDSBORO PA
19508-8136
US

IV. Provider business mailing address

PO BOX 636
BIRDSBORO PA
19508-0636
US

V. Phone/Fax

Practice location:
  • Phone: 610-779-2020
  • Fax: 610-404-1011
Mailing address:
  • Phone: 610-779-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000263
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: