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General NPI Number Information
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NPI Number | 1568157725
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Entity Type | Individual
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Provider Name | JEAN DELISI FNP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 649 ROUTE 25A STE 3
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City | ROCKY POINT
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State | NY
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Zip | 11778-8983
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Country | US
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Telephone | 631-509-0671
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Fax | 631-509-0672
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Provider Business Mailing Address
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Address Line | 73 CAMPBELL LN
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City | EAST ISLIP
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State | NY
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Zip | 11730-3616
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Country | US
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Telephone | 631-988-1222
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 350661
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License Number State | NY
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