=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992593966
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DELAWARE VALLEY HOSPITAL, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2025
-----------------------------------------------------
Last Update Date | 04/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 TITUS PL
-----------------------------------------------------
City | WALTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13856-1457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-865-2100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 TITUS PL
-----------------------------------------------------
City | WALTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13856-1457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-865-2100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS OFFICE MANAGER
-----------------------------------------------------
Name | DONNA BANKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 607-865-2191
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------