Provider Demographics
NPI:1407885106
Name:DELGADO, MING L (PT)
Entity Type:Individual
Prefix:MRS
First Name:MING
Middle Name:L
Last Name:DELGADO
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 1:50 S BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2906
Mailing Address - Country:US
Mailing Address - Phone:908-218-4244
Mailing Address - Fax:908-218-4233
Practice Address - Street 1:50 S BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2906
Practice Address - Country:US
Practice Address - Phone:908-218-4244
Practice Address - Fax:908-218-4233
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01013500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076742SHNMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER