Provider Demographics
NPI:1336699693
Name:DALBEY, RANDY
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:DALBEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 W 16TH ST
Mailing Address - Street 2:APT 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:223 W 16TH ST
Practice Address - Street 2:APT 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6012
Practice Address - Country:US
Practice Address - Phone:201-912-1948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY630954163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse