Provider Demographics
NPI:1760466387
Name:DALY, PAMELA LYNN (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LYNN
Last Name:DALY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ONEWEST MEDICAL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12020
Mailing Address - Country:US
Mailing Address - Phone:518-584-1590
Mailing Address - Fax:518-584-2205
Practice Address - Street 1:ONEWEST MEDICAL
Practice Address - Street 2:SUITE 200
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12020
Practice Address - Country:US
Practice Address - Phone:518-584-1590
Practice Address - Fax:518-584-2205
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004977-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01346345Medicaid
NY01346345Medicaid
NY53445BMedicare PIN