Provider Demographics
NPI:1275719577
Name:DELERME, IVETTE ANN
Entity Type:Individual
Prefix:
First Name:IVETTE
Middle Name:ANN
Last Name:DELERME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 CARMANS RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3504
Mailing Address - Country:US
Mailing Address - Phone:516-795-1589
Mailing Address - Fax:519-795-2032
Practice Address - Street 1:901 CARMANS RD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-3504
Practice Address - Country:US
Practice Address - Phone:516-795-1589
Practice Address - Fax:519-795-2032
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040016183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist