JOHN EDWARD DELORIA

BAYSIDE, NY
NPI1760726707
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: NY  135764-1)
Enumeration Date2012-11-15
Last Update Date2019-11-08
Business Address
Dr. JOHN EDWARD DELORIA MD
3835 204TH ST
BAYSIDE, NY 11361
Phone number: 718-974-1879
Mailing Address
Dr. JOHN EDWARD DELORIA MD
3835 204TH ST
BAYSIDE, NY 11361-1864
Phone number: 718-974-1879
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