Provider Demographics
NPI:1508194853
Name:GEORGE, DELIA J (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:J
Last Name:GEORGE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 WEST AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-4648
Mailing Address - Country:US
Mailing Address - Phone:347-355-9377
Mailing Address - Fax:
Practice Address - Street 1:276 WEST AVE APT 3
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4648
Practice Address - Country:US
Practice Address - Phone:347-355-9377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286759164W00000X
CT176126175M00000X
CT374J00000X
NY374J00000X
NY625438163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No175M00000XOther Service ProvidersMidwife, Lay
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY625438OtherPROFESSIONAL REGISTERED NURSE