Provider Demographics
NPI:1699458281
Name:LANCOR, DELANEY ELLEN
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:ELLEN
Last Name:LANCOR
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 1:94 HAVENHURST RD
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-2161
Mailing Address - Country:US
Mailing Address - Phone:508-223-6070
Mailing Address - Fax:
Practice Address - Street 1:85 SEYMOUR ST STE 700
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5533
Practice Address - Country:US
Practice Address - Phone:860-696-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT137927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily