Provider Demographics
NPI:1629890496
Name:DELANTY, DANIEL ROBERT NORMAN (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ROBERT NORMAN
Last Name:DELANTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:DAN
Other - Middle Name:ROBERT
Other - Last Name:DELANTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1901 D ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2534
Mailing Address - Country:US
Mailing Address - Phone:202-588-1112
Mailing Address - Fax:
Practice Address - Street 1:1901 D ST SE
Practice Address - Street 2:1901 D ST SE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2534
Practice Address - Country:US
Practice Address - Phone:202-588-1112
Practice Address - Fax:202-204-6267
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRBT-24-380821106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician