Provider Demographics
NPI:1801049184
Name:PAIGE-DELAHAYE, AIRNEEZER (PTA)
Entity type:Individual
Prefix:MS
First Name:AIRNEEZER
Middle Name:
Last Name:PAIGE-DELAHAYE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LEADER DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1943
Mailing Address - Country:US
Mailing Address - Phone:570-323-8627
Mailing Address - Fax:
Practice Address - Street 1:300 LEADER DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1943
Practice Address - Country:US
Practice Address - Phone:570-323-8627
Practice Address - Fax:570-323-5820
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE002716L314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility