Provider Demographics
NPI:1740854512
Name:SALLY DELORY NP IN FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:SALLY DELORY NP IN FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-227-5339
Mailing Address - Street 1:2 EXECUTIVE PARK DRIVE,
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3700
Mailing Address - Country:US
Mailing Address - Phone:518-323-2828
Mailing Address - Fax:518-313-5860
Practice Address - Street 1:2 EXECUTIVE PARK DRIVE,
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3700
Practice Address - Country:US
Practice Address - Phone:518-323-2828
Practice Address - Fax:518-313-5860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service