Provider Demographics
NPI:1851370563
Name:DULAY & DULAY MD PC
Entity Type:Organization
Organization Name:DULAY & DULAY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:CASTILLO
Authorized Official - Last Name:DULAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-432-5777
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:223 BROADWAY
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144
Mailing Address - Country:US
Mailing Address - Phone:518-432-5777
Mailing Address - Fax:518-432-6667
Practice Address - Street 1:223 BROADWAY
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144
Practice Address - Country:US
Practice Address - Phone:518-432-5777
Practice Address - Fax:518-432-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1150721207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
10000538 D890OtherCDPHP
000401134002OtherBS
NY00531324Medicaid
76E911OtherBC
10000538 D890OtherCDPHP
000401134002OtherBS