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NPI Code Detail

MEDICARE: CHRISTOPHER D DELENICK OT

MEDICARE: CHRISTOPHER D DELENICK OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT1854ME

General Provider Information

NPI Number : 1346696903
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER D DELENICK OT
Provider Business Mailing Address
First Line : 127 MAIN ST
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-2647
Country : US
Telephone Number : 207-767-2189
Fax Number : 207-799-8346
Provider Business Practice Location Address
First Line : 127 MAIN ST
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-2647
Country : US
Telephone Number : 207-767-2189
Fax Number : 207-799-8346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2016
Last Update Date : 05/12/2016

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Directions to “ CHRISTOPHER D DELENICK OT” Practice Location

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