Provider Demographics
NPI:1831219393
Name:DALY, FARRAH NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:FARRAH
Middle Name:NICOLE
Last Name:DALY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:673 POTOMAC STATION DR NE # 605
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-1819
Mailing Address - Country:US
Mailing Address - Phone:540-924-3258
Mailing Address - Fax:856-249-9592
Practice Address - Street 1:673 POTOMAC STATION DR NE
Practice Address - Street 2:# 605
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-1819
Practice Address - Country:US
Practice Address - Phone:540-924-3258
Practice Address - Fax:856-249-9592
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA01012413912084H0002X
VA01012413912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084H0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyHospice and Palliative Medicine