Provider Demographics
NPI:1922661412
Name:DELGADO HERNANDEZ, FEDERICO ANDRES (MD)
Entity Type:Individual
Prefix:MR
First Name:FEDERICO ANDRES
Middle Name:
Last Name:DELGADO HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:HHC-CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:475-210-5022
Practice Address - Street 1:2800 MAIN STREET
Practice Address - Street 2:DEPARTMENT OF MEDICINE
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606
Practice Address - Country:US
Practice Address - Phone:475-210-5718
Practice Address - Fax:475-210-5263
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2023-06-28
Deactivation Date:2019-12-04
Deactivation Code:
Reactivation Date:2020-07-15
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT72543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program