Provider Demographics
NPI:1568005940
Name:DALEY, TESHNA A (LPN)
Entity Type:Individual
Prefix:
First Name:TESHNA
Middle Name:A
Last Name:DALEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CASALS PL APT 26K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3153
Mailing Address - Country:US
Mailing Address - Phone:718-496-5372
Mailing Address - Fax:
Practice Address - Street 1:120 CASALS PL APT 26K
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-3153
Practice Address - Country:US
Practice Address - Phone:718-496-5372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2705421164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse