Provider Demographics
NPI:1417240201
Name:DELMAN, BETHANY M (DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:M
Last Name:DELMAN
Suffix:
Gender:F
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 BROADWAY
Mailing Address - Street 2:STE 305
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5872
Mailing Address - Country:US
Mailing Address - Phone:212-579-3539
Mailing Address - Fax:212-579-3530
Practice Address - Street 1:2255 BROADWAY
Practice Address - Street 2:STE 305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5872
Practice Address - Country:US
Practice Address - Phone:212-579-3539
Practice Address - Fax:212-579-3530
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195022251X0800X
NY0385602251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic