Provider Demographics
NPI:1295387850
Name:DELILLO, CHRISTEN MARIE
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:MARIE
Last Name:DELILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MEADOWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FORT SALONGA
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2702
Mailing Address - Country:US
Mailing Address - Phone:516-318-8646
Mailing Address - Fax:
Practice Address - Street 1:6 MEADOWOOD LN
Practice Address - Street 2:
Practice Address - City:FORT SALONGA
Practice Address - State:NY
Practice Address - Zip Code:11768-2702
Practice Address - Country:US
Practice Address - Phone:516-318-8646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-14
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist