Provider Demographics
NPI:1124195490
Name:DELAHANTY, MAUREEN C (DC)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:C
Last Name:DELAHANTY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:12117-0453
Mailing Address - Country:US
Mailing Address - Phone:518-661-7781
Mailing Address - Fax:
Practice Address - Street 1:2424 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:NY
Practice Address - Zip Code:12117-4000
Practice Address - Country:US
Practice Address - Phone:518-661-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55920CMedicare ID - Type Unspecified