Provider Demographics
NPI:1336511740
Name:DELGADO, MELODY (REGISTED NURSE)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:REGISTED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2488 GRAND CONCOURSE
Mailing Address - Street 2:ROOM 409
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5203
Mailing Address - Country:US
Mailing Address - Phone:718-305-5858
Mailing Address - Fax:
Practice Address - Street 1:2488 GRAND CONCOURSE
Practice Address - Street 2:ROOM 409
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5203
Practice Address - Country:US
Practice Address - Phone:718-305-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-25
Last Update Date:2015-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY664183163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health