Provider Demographics
NPI:1013674878
Name:DELPECHE, PATRICK RONALD
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:RONALD
Last Name:DELPECHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198-27 UNIT #1 DUNTON AVE
Mailing Address - Street 2:UNIT #1
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423
Mailing Address - Country:US
Mailing Address - Phone:347-484-8669
Mailing Address - Fax:
Practice Address - Street 1:198-27 UNIT #1 DUNTON AVE
Practice Address - Street 2:UNIT #1
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423
Practice Address - Country:US
Practice Address - Phone:347-484-8669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224030-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse