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General NPI Number Information
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NPI Number | 1558468272
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Entity Type | Individual
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Provider Name | KAREN M DELESKI M.S, ATC, LMT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 141 NARROW LN
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-3050
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Country | US
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Telephone | 516-383-5484
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Fax |
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Provider Business Mailing Address
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Address Line | 9 CROWN LN
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City | SAG HARBOR
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State | NY
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Zip | 11963-2336
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Country | US
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Telephone | 516-383-5484
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000687-1
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License Number State | NY
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