Provider Demographics
NPI:1871662718
Name:DELGADO, JOSE SOARES (MA)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:SOARES
Last Name:DELGADO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MAYFLOWER ST
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-1824
Mailing Address - Country:US
Mailing Address - Phone:401-438-8622
Mailing Address - Fax:508-999-6607
Practice Address - Street 1:466 COUNTY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5107
Practice Address - Country:US
Practice Address - Phone:508-997-0794
Practice Address - Fax:508-999-6607
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health