Provider Demographics
NPI:1740760602
Name:DELGADO, JANET LIZETTE (BCBA)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:LIZETTE
Last Name:DELGADO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BUXTON FARM RD STE 105
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3614 195TH ST
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:NY
Practice Address - Zip Code:11358-4015
Practice Address - Country:US
Practice Address - Phone:917-266-7599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst