Provider Demographics
NPI:1609851948
Name:DALY, MARY K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:DALY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2005 BAY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1085
Mailing Address - Country:US
Mailing Address - Phone:508-823-7473
Mailing Address - Fax:508-824-3830
Practice Address - Street 1:2005 BAY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-1085
Practice Address - Country:US
Practice Address - Phone:508-823-7473
Practice Address - Fax:508-824-3830
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA226184207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA45427OtherHARVARD PILGRIM HEALTH CA
MA2110881Medicaid
MAJ29470OtherBCBS
MAAA45427OtherHARVARD PILGRIM HEALTH CA
MAI01840Medicare UPIN