Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003224973 |
---|---|
Provider Name | Jeanine Michele Delgado |
First Address | Northport, NY 11768-2200 |
Second Address | Northport, NY 11768-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 31/01/2022 |