Provider Demographics
NPI:1790756567
Name:DAYTON, PAMELA L (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:L
Last Name:DAYTON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 PLANDOME RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1966
Mailing Address - Country:US
Mailing Address - Phone:516-365-1700
Mailing Address - Fax:516-365-7565
Practice Address - Street 1:509 PLANDOME RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1966
Practice Address - Country:US
Practice Address - Phone:516-365-1700
Practice Address - Fax:516-365-7565
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004632213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU13362Medicare UPIN
NYP50901Medicare ID - Type Unspecified