Individual provider Active NPI

Maureen Anne Boller Delaney, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson Heights, NY
National Provider Identifier
1629052972
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400514 - 1 Issued in NY
Practice address
75-20 Astoria Blvd.
Jackson Heights, NY 11370
Phone
(718) 888-6794
Fax
(718) 565-8392
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F400514 - 1 NY Primary

Addresses

Primary practice location

75-20 Astoria Blvd.
Jackson Heights, NY 11370

Mailing address

314 Foster Ave
Sayville, NY 11782-3153
Phone (917) 837-2551

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F400514 - 1NYMDPsychiatric/Mental Health Nurse Practitioner

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1629052972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 FOSTER AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823153",
            "telephone_number": "917-837-2551",
            "fax_number": "718-565-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-20 ASTORIA BLVD.",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11370",
            "telephone_number": "718-888-6794",
            "fax_number": "718-565-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLER DELANEY",
        "first_name": "MAUREEN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400514 - 1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.