Provider Demographics
NPI:1578679759
Name:DELPHIN, JACQUES M (MD)
Entity Type:Individual
Prefix:
First Name:JACQUES
Middle Name:M
Last Name:DELPHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:20 DAVIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2408
Mailing Address - Country:US
Mailing Address - Phone:845-485-3500
Mailing Address - Fax:845-485-8780
Practice Address - Street 1:510 HAIGHT AVENUE SUITE 102
Practice Address - Street 2:SPRECTRUM BEHAVIORAL MANAGEMENT SERV INC
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2408
Practice Address - Country:US
Practice Address - Phone:845-485-9098
Practice Address - Fax:845-485-8780
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY985442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
1033150OtherBEACON HEALTH STRAT
0050145OtherVALUEOPTIONS EMPIRE
1027945OtherCIGNA BEH HEALTH
16111OtherPONCO
137126OtherVALUEOPTIONS
10033708OtherCDPHP
5242751OtherAETNA
361015OtherMVP HEALTH CARE
0050145OtherVALUEOPTIONS EMPIRE
137126OtherVALUEOPTIONS