Provider Demographics
NPI:1952441107
Name:DELANEY, JEROME P (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEROME
Middle Name:P
Last Name:DELANEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44 CARMOLITE DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3613
Mailing Address - Country:US
Mailing Address - Phone:716-667-6914
Mailing Address - Fax:716-667-6915
Practice Address - Street 1:3671 SOUTHWESTERN BLVD
Practice Address - Street 2:SUITE 113
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1752
Practice Address - Country:US
Practice Address - Phone:716-667-6914
Practice Address - Fax:716-667-6915
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist