Provider Demographics
NPI:1114546207
Name:DELANEY, EMILY NICOLE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:DELANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5783 WOOSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8816
Mailing Address - Country:US
Mailing Address - Phone:307-250-5693
Mailing Address - Fax:
Practice Address - Street 1:5783 WOOSTER PIKE
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8816
Practice Address - Country:US
Practice Address - Phone:330-725-0569
Practice Address - Fax:330-662-0258
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.149720207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology