Provider Demographics
NPI:1174730329
Name:DALY FOOT CARE, PC
Entity type:Organization
Organization Name:DALY FOOT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:781-322-7716
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-0002
Mailing Address - Country:US
Mailing Address - Phone:781-322-7716
Mailing Address - Fax:781-322-7727
Practice Address - Street 1:253 SALEM ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-4118
Practice Address - Country:US
Practice Address - Phone:781-322-7716
Practice Address - Fax:781-322-7727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2118213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9704353Medicaid
MAY78026Medicare PIN
MA9704353Medicaid