Basic Information
Provider Information
NPI: 1790722742
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DALY
FirstName: JANE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 441 9TH AVE FL 3
Address2:  
City: NEW YORK
State: NY
PostalCode: 100011623
CountryCode: US
TelephoneNumber: 5165426880
FaxNumber: 5165425556
Practice Location
Address1: 9610 METROPOLITAN AVE
Address2:  
City: FOREST HILLS
State: NY
PostalCode: 113756625
CountryCode: US
TelephoneNumber: 7184590400
FaxNumber: 7182863863
Other Information
ProviderEnumerationDate: 05/31/2006
LastUpdateDate: 03/30/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X133139NYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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