Provider Demographics
NPI:1295079325
Name:DELGADO, JENNIFER MARIE (NP)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:MARIE
Last Name:DELGADO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VALLEY HEALTH PLZ
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3628
Mailing Address - Country:US
Mailing Address - Phone:201-634-5401
Mailing Address - Fax:201-634-5381
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-634-5401
Practice Address - Fax:201-634-5381
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2012-11-15
Deactivation Date:2012-09-28
Deactivation Code:
Reactivation Date:2012-11-14
Provider Licenses
StateLicense IDTaxonomies
NYF333957-1363LF0000X
NJ26NJ00170000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily