Provider Demographics
NPI:1710119417
Name:DELFENIC ENTERPRISES, INC.
Entity Type:Organization
Organization Name:DELFENIC ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AUDLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-882-2490
Mailing Address - Street 1:951 E 218TH ST
Mailing Address - Street 2:P.O. BOX 690085
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-1005
Mailing Address - Country:US
Mailing Address - Phone:718-882-2490
Mailing Address - Fax:718-653-1977
Practice Address - Street 1:951 E 218TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-1005
Practice Address - Country:US
Practice Address - Phone:718-882-2490
Practice Address - Fax:718-653-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)