Provider Demographics
NPI:1932220746
Name:DELANEY, KRISTEN JONELLE (RPA-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JONELLE
Last Name:DELANEY
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 LONGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:11953-2045
Mailing Address - Country:US
Mailing Address - Phone:516-721-2879
Mailing Address - Fax:631-924-4298
Practice Address - Street 1:35 LONGWOOD RD
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-2045
Practice Address - Country:US
Practice Address - Phone:631-924-1000
Practice Address - Fax:631-924-4298
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2010-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010289363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical