Provider Demographics
NPI:1821154766
Name:GRACY, DELANEY K (MD)
Entity Type:Individual
Prefix:
First Name:DELANEY
Middle Name:K
Last Name:GRACY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 S MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5603
Mailing Address - Country:US
Mailing Address - Phone:212-535-9779
Mailing Address - Fax:212-535-7699
Practice Address - Street 1:NY CHILDREN'S HEALTH PROJECT
Practice Address - Street 2:317 EAST 64TH STREET
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-535-9779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224821208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics