Provider Demographics
NPI:1831437813
Name:DALY, CYNTHIA DALE
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DALE
Last Name:DALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2946 REDFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-3754
Mailing Address - Country:US
Mailing Address - Phone:908-361-2363
Mailing Address - Fax:
Practice Address - Street 1:2946 REDFIELD DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-3754
Practice Address - Country:US
Practice Address - Phone:908-361-2363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC222Q00000X171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor