Provider Demographics
NPI:1982665261
Name:DELMAN, MOISEY (MD)
Entity Type:Individual
Prefix:
First Name:MOISEY
Middle Name:
Last Name:DELMAN
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 1:32 GREEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576
Mailing Address - Country:US
Mailing Address - Phone:718-275-2669
Mailing Address - Fax:718-275-2686
Practice Address - Street 1:9508 QUEENS BLVD
Practice Address - Street 2:#1E
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1159
Practice Address - Country:US
Practice Address - Phone:718-275-2669
Practice Address - Fax:718-275-2686
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200179207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01592896Medicaid
G16824Medicare UPIN
NY01592896Medicaid