Provider Demographics
NPI:1194767236
Name:DELMONTE, MARK LOUIS (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:LOUIS
Last Name:DELMONTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1922
Mailing Address - Country:US
Mailing Address - Phone:716-285-0391
Mailing Address - Fax:716-285-0392
Practice Address - Street 1:1410 PINE AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1922
Practice Address - Country:US
Practice Address - Phone:716-285-0391
Practice Address - Fax:716-285-0392
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor