MEDICARE: DR. BRIAN L DELANEY PSY.D.

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
1	103TC0700X	Clinical Psychologist	8085	MA

General Provider Information

NPI Number	:	1992784581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN L DELANEY PSY.D.

Provider Business Mailing Address
First Line	:	23 CHESTER RD
Second Line	:	2
City	:	BELMONT
State	:	MA
Zip	:	02478-2805
Country	:	US
Telephone Number	:	617-632-4206
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 HIGHLAND AVE
Second Line	:	J
City	:	SOMERVILLE
State	:	MA
Zip	:	02144-2548
Country	:	US
Telephone Number	:	617-429-0714
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/08/2007

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