Provider Demographics
NPI:1528390101
Name:DELEHANT, DAVID C (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:DELEHANT
Suffix:
Gender:M
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PARK ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5125
Mailing Address - Country:US
Mailing Address - Phone:845-338-6745
Mailing Address - Fax:845-338-6745
Practice Address - Street 1:11 PARK ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5125
Practice Address - Country:US
Practice Address - Phone:845-338-6745
Practice Address - Fax:845-338-6745
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009703-1225X00000X, 225XH1200X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand