Provider Demographics
NPI:1285816686
Name:DALEY, DEVORAH (MD)
Entity Type:Individual
Prefix:
First Name:DEVORAH
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 BROADWAY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3225
Mailing Address - Country:US
Mailing Address - Phone:212-966-7600
Mailing Address - Fax:212-925-8736
Practice Address - Street 1:568 BROADWAY
Practice Address - Street 2:SUITE 304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3225
Practice Address - Country:US
Practice Address - Phone:212-966-7600
Practice Address - Fax:212-925-8736
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248403-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology