Provider Demographics
NPI:1043742638
Name:SCHMIDT DELGADO, JOANNE M
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:SCHMIDT DELGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:M
Other - Last Name:SCHMIDT DELGADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:493 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2722
Mailing Address - Country:US
Mailing Address - Phone:631-671-4946
Mailing Address - Fax:
Practice Address - Street 1:493 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2722
Practice Address - Country:US
Practice Address - Phone:631-671-4946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226295-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse