Provider Demographics
NPI:1356463798
Name:DALY, THERESA M (FNP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:M
Last Name:DALY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 ELDORADO CT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1558
Mailing Address - Country:US
Mailing Address - Phone:914-993-6498
Mailing Address - Fax:914-993-6497
Practice Address - Street 1:622 W 168TH ST PH 14-104
Practice Address - Street 2:LUNG TRANSPLANT PROGRAM - NYPH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-7771
Practice Address - Fax:212-342-2792
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily