Provider Demographics
NPI:1093395006
Name:DELAHANTY, JESSICA (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DELAHANTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 ALBANY STREET
Mailing Address - Street 2:SHAPIRO PRIMARY CARE, PRECEPTING ROOM
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-3549
Mailing Address - Country:US
Mailing Address - Phone:617-494-5951
Mailing Address - Fax:
Practice Address - Street 1:725 ALBANY STREET
Practice Address - Street 2:SHAPIRO PRIMARY CARE, PRECEPTING ROOM
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-3549
Practice Address - Country:US
Practice Address - Phone:617-494-5951
Practice Address - Fax:617-494-9251
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program