Provider Demographics
NPI:1760746937
Name:NELLY MERCEDES DELGROSSO
Entity Type:Organization
Organization Name:NELLY MERCEDES DELGROSSO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NELLY
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:DELGROSSO
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:917-889-0627
Mailing Address - Street 1:9811 162ND AVE
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3908
Mailing Address - Country:US
Mailing Address - Phone:718-738-3764
Mailing Address - Fax:
Practice Address - Street 1:9811 162ND AVE
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3908
Practice Address - Country:US
Practice Address - Phone:917-889-0627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency