Provider Demographics
NPI:1558468272
Name:DELESKI, KAREN M (MS, ATC, LMT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:DELESKI
Suffix:
Gender:F
Credentials:MS, ATC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CROWN LN
Mailing Address - Street 2:
Mailing Address - City:SAG HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11963-2336
Mailing Address - Country:US
Mailing Address - Phone:516-383-5484
Mailing Address - Fax:
Practice Address - Street 1:141 NARROW LN
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-3050
Practice Address - Country:US
Practice Address - Phone:516-383-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000687-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer