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General NPI Number Information
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NPI Number | 1598028961
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Entity Type | Individual
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Provider Name | KELLY ANN DELIONADO MS
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Gender | Male
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 20 CEDAR ST
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5247
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Country | US
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Telephone | 914-576-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 403 HIGH MEADOW LN
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-1224
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Country | US
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Telephone | 914-874-4563
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 514397041
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License Number State | NY
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