Basic Information
Provider Information
NPI: 1447678826
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DALY GURIS
FirstName: RODRIGO
MiddleName: JAVIER
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DALY
OtherFirstName: RODRIGO
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MBBS
OtherLastNameType: 2
Mailing Information
Address1: 100 PENN SQUARE EAST
Address2: 9TH FLOOR NORTH - CAA
City: PHILADELPHIA
State: PA
PostalCode: 19107
CountryCode: US
TelephoneNumber: 2674259309
FaxNumber: 2674259331
Practice Location
Address1: 3401 CIVIC CENTER BLVD STE 9329
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191044319
CountryCode: US
TelephoneNumber: 2155901858
FaxNumber: 2155901415
Other Information
ProviderEnumerationDate: 04/02/2014
LastUpdateDate: 10/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP3000XMD463658PAY Allopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology

No ID Information.


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