Basic Information
Provider Information
NPI: 1720176944
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DALY
FirstName: PATRICIA
MiddleName: MARIE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1345 RXR PLZ FL 13
Address2:  
City: UNIONDALE
State: NY
PostalCode: 115561301
CountryCode: US
TelephoneNumber: 5164530435
FaxNumber: 6468463283
Practice Location
Address1: 1850 SUNRISE HWY
Address2:  
City: BAY SHORE
State: NY
PostalCode: 117066012
CountryCode: US
TelephoneNumber: 6315815900
FaxNumber: 6319681792
Other Information
ProviderEnumerationDate: 10/11/2006
LastUpdateDate: 12/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/11/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X233782NYY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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