Provider Demographics
NPI:1457506966
Name:DELGADO, YOLANDA CECILIA (OTR)
Entity Type:Individual
Prefix:MISS
First Name:YOLANDA
Middle Name:CECILIA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 05 HOOVER AVE
Mailing Address - Street 2:6C
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:917-608-8352
Mailing Address - Fax:
Practice Address - Street 1:9745 QUEENS BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2116
Practice Address - Country:US
Practice Address - Phone:718-830-9274
Practice Address - Fax:718-830-9276
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010433-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010433-1OtherNEW YORK STATE