Provider Demographics
NPI:1376651083
Name:DALY, CELINE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CELINE MARIE
Middle Name:
Last Name:DALY
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:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:KILL BUCK
Mailing Address - State:NY
Mailing Address - Zip Code:14748-0024
Mailing Address - Country:US
Mailing Address - Phone:716-945-2619
Mailing Address - Fax:
Practice Address - Street 1:6549 HARDSCRABBLE ROAD
Practice Address - Street 2:
Practice Address - City:KILL BUCK
Practice Address - State:NY
Practice Address - Zip Code:14748
Practice Address - Country:US
Practice Address - Phone:716-945-2619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine