Provider Demographics
NPI:1942226576
Name:PAMELA L DALY, DPM
Entity type:Organization
Organization Name:PAMELA L DALY, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-584-1590
Mailing Address - Street 1:1 WEST AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6045
Mailing Address - Country:US
Mailing Address - Phone:518-584-1590
Mailing Address - Fax:518-584-2205
Practice Address - Street 1:1 WEST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6045
Practice Address - Country:US
Practice Address - Phone:518-584-1590
Practice Address - Fax:518-584-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004977213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01346345Medicaid
NY0898540001Medicare NSC
31300Medicare UPIN
NY53445BMedicare PIN