Provider Demographics
NPI:1124535026
Name:DELIROD, RANDI SUE (MA, LMSW)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:SUE
Last Name:DELIROD
Suffix:
Gender:F
Credentials:MA, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTH CENTRAL BRONX HOSPITAL, DEPT. OF SOCIAL WORK
Mailing Address - Street 2:3424 KOSSUTH AVE.
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2410
Mailing Address - Country:US
Mailing Address - Phone:718-530-3100
Mailing Address - Fax:
Practice Address - Street 1:NORTH CENTRAL BRONX HOSPITAL, DEPT. OF SOCIAL WORK
Practice Address - Street 2:3424 KOSSUTH AVE.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2410
Practice Address - Country:US
Practice Address - Phone:718-530-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102589104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker