Provider Demographics
NPI:1629356480
Name:DELGIACCO, MAUREEN C (PHD, LCAT)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:C
Last Name:DELGIACCO
Suffix:
Gender:F
Credentials:PHD, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 LISHAKILL RD
Mailing Address - Street 2:
Mailing Address - City:COLONIE
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3612
Mailing Address - Country:US
Mailing Address - Phone:518-248-2757
Mailing Address - Fax:
Practice Address - Street 1:27 LISHAKILL RD
Practice Address - Street 2:
Practice Address - City:COLONIE
Practice Address - State:NY
Practice Address - Zip Code:12205-3612
Practice Address - Country:US
Practice Address - Phone:518-248-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000374-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist