Provider Demographics
NPI:1881016251
Name:DELICE, SHANYKA (IOMT)
Entity Type:Individual
Prefix:
First Name:SHANYKA
Middle Name:
Last Name:DELICE
Suffix:
Gender:F
Credentials:IOMT
Other - Prefix:
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Mailing Address - Street 1:PO BOX 26145
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-0045
Mailing Address - Country:US
Mailing Address - Phone:410-983-9246
Mailing Address - Fax:410-995-2124
Practice Address - Street 1:307 S HENRY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5900
Practice Address - Country:US
Practice Address - Phone:410-983-9246
Practice Address - Fax:410-995-2124
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic