Provider Demographics
NPI:1104989805
Name:DELANEY, KATRENE MARIE (PT)
Entity type:Individual
Prefix:MS
First Name:KATRENE
Middle Name:MARIE
Last Name:DELANEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 ROUTE 59
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4927
Mailing Address - Country:US
Mailing Address - Phone:845-368-4111
Mailing Address - Fax:845-368-4114
Practice Address - Street 1:100 ROUTE 59
Practice Address - Street 2:SUITE 103
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4927
Practice Address - Country:US
Practice Address - Phone:845-368-4111
Practice Address - Fax:845-368-4114
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0219531174400000X
NY021953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ107E1Medicare PIN