Provider Demographics
NPI:1003831108
Name:DELANEY, ROBERT E (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:DELANEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:40 MAIN ST
Mailing Address - Street 2:STE 106
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3100
Mailing Address - Country:US
Mailing Address - Phone:413-584-6422
Mailing Address - Fax:413-584-4346
Practice Address - Street 1:40 MAIN STREET
Practice Address - Street 2:SUITE 6
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062
Practice Address - Country:US
Practice Address - Phone:413-584-6422
Practice Address - Fax:413-584-4346
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3224152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0353132Medicaid
MA0353132Medicaid
MA401058Medicare PIN