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General NPI Number Information
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NPI Number | 1922050749
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Entity Type | Organization
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Legal Business Name | JACQUELINE DELMONT MD PC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 55 N MAIN ST
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City | FREEPORT
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State | NY
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Zip | 11520-2243
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Country | US
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Telephone | 516-377-8014
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Fax | 516-377-8017
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Provider Business Mailing Address
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Address Line | 55 N MAIN ST
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City | FREEPORT
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State | NY
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Zip | 11520-2243
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Country | US
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Telephone | 516-377-8014
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Fax | 516-377-8107
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JACQUELINE DELMONT
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Credential | M.D.
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Telephone | 516-377-8014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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