Richard Delnunzio, M.D.

Individual provider Active NPI Internal Medicine Physician · Edgemere, NY

NPI 1487697108 · NPPES record last updated Oct 11, 2007

Key facts

NPI
1487697108
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
154123 (NY)
Practice address
353 Beach 48 Street
Edgemere, NY 11691
Phone
(718) 471-5000
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
154123NYMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 154123 NY Yes

Addresses

Primary practice location

353 Beach 48 Street
Edgemere, NY 11691

Mailing address

43 Exeter St
Forest Hills, NY 11375-5146
Phone (718) 471-5000

Other identifiers

IdentifierTypeStateIssuer
00860444MedicaidNY

Sources for this page

Verify at the official NPI Registry.