Provider Demographics
NPI:1598263790
Name:DELPECHE, GREGOR YVES (DR)
Entity Type:Individual
Prefix:
First Name:GREGOR
Middle Name:YVES
Last Name:DELPECHE
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HILLVALE RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6916
Mailing Address - Country:US
Mailing Address - Phone:516-771-0090
Mailing Address - Fax:
Practice Address - Street 1:905 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2417
Practice Address - Country:US
Practice Address - Phone:718-773-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool