Provider Demographics
NPI:1245589001
Name:DELINA, LEILYN E (PT)
Entity Type:Individual
Prefix:MRS
First Name:LEILYN
Middle Name:E
Last Name:DELINA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 57TH RD
Mailing Address - Street 2:APT 3F
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4845
Mailing Address - Country:US
Mailing Address - Phone:201-936-4639
Mailing Address - Fax:
Practice Address - Street 1:8614 57TH RD
Practice Address - Street 2:APT 3F
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4845
Practice Address - Country:US
Practice Address - Phone:201-936-4639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist