Provider Demographics
NPI:1144380346
Name:DALEY, CARLENE J (NP RNP)
Entity Type:Individual
Prefix:MS
First Name:CARLENE
Middle Name:J
Last Name:DALEY
Suffix:
Gender:F
Credentials:NP RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5423 FILLMORE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234
Mailing Address - Country:US
Mailing Address - Phone:718-245-5482
Mailing Address - Fax:718-245-3061
Practice Address - Street 1:451 CLARKSON AVENUE
Practice Address - Street 2:E BUILDING SUITE 6B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-5482
Practice Address - Fax:718-245-3061
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420314363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology