Provider Demographics
NPI:1750502787
Name:WRIGHT, DELORES MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DELORES
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1127
Mailing Address - Country:US
Mailing Address - Phone:631-842-0043
Mailing Address - Fax:
Practice Address - Street 1:1417 LOMBARDY BLVD
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-4046
Practice Address - Country:US
Practice Address - Phone:631-647-7558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088108164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse