Provider Demographics
NPI:1134109101
Name:DALY, JOHN J III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:DALY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1350 EDGMONT AVE
Mailing Address - Street 2:STE 1500
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3962
Mailing Address - Country:US
Mailing Address - Phone:302-633-5840
Mailing Address - Fax:302-633-5844
Practice Address - Street 1:2502 SILVERSIDE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3740
Practice Address - Country:US
Practice Address - Phone:302-479-0500
Practice Address - Fax:302-479-0599
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2018-10-31
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Provider Licenses
StateLicense IDTaxonomies
PAOS007873L207Q00000X
DEC2-0007134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE61684868OtherBCBS OF DE
DEG01688Medicare ID - Type Unspecified
DE61684868OtherBCBS OF DE