NPI Code Details Logo

NPI 1861396053

NPI 1861396053 : DELANEY SHEA GUARD PT : GREENPORT, NY

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1861396053
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DELANEY SHEA GUARD PT
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/02/2026
-----------------------------------------------------
    Last Update Date     |    10/02/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    61700 COUNTY ROUTE 48 
-----------------------------------------------------
    City                 |    GREENPORT
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    11944-2206
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    631-477-2110
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    7157 LAKESHORE RD 
-----------------------------------------------------
    City                 |    CICERO
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    13039-9733
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    315-310-3569
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    056106
-----------------------------------------------------
    License Number State |    NY
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.