Provider Demographics
NPI:1295910552
Name:DELORME, VERA S (MA)
Entity type:Individual
Prefix:MRS
First Name:VERA
Middle Name:S
Last Name:DELORME
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BROAD ST
Mailing Address - Street 2:224 SIBLEY HALL
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2637
Mailing Address - Country:US
Mailing Address - Phone:518-564-2170
Mailing Address - Fax:518-564-5110
Practice Address - Street 1:101 BROAD ST
Practice Address - Street 2:224 SIBLEY HALL
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2637
Practice Address - Country:US
Practice Address - Phone:518-564-2170
Practice Address - Fax:518-564-5110
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014921-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56950AMedicare PIN