Provider Demographics
NPI:1942416771
Name:PALEY, DEANA E (DO)
Entity Type:Individual
Prefix:DR
First Name:DEANA
Middle Name:E
Last Name:PALEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 WASHINGTON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4083
Mailing Address - Country:US
Mailing Address - Phone:315-755-3650
Mailing Address - Fax:315-755-3669
Practice Address - Street 1:629 WASHINGTON ST STE 1
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4083
Practice Address - Country:US
Practice Address - Phone:315-755-3650
Practice Address - Fax:315-755-3669
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2490512082S0105X, 208600000X, 208200000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03488153Medicaid
NY03488153Medicaid