Provider Demographics
NPI:1376981076
Name:DELINO, PEGGY YENTZEN (ARRT,CMD)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:YENTZEN
Last Name:DELINO
Suffix:
Gender:F
Credentials:ARRT,CMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 MARILYN LN
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-5316
Mailing Address - Country:US
Mailing Address - Phone:409-729-7017
Mailing Address - Fax:
Practice Address - Street 1:11623 ARBOR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2981
Practice Address - Country:US
Practice Address - Phone:866-334-1919
Practice Address - Fax:402-334-6009
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other