Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS015738 | PA |
NPI | 1003074006 |
---|---|
Provider Name | Dr. Timothy Matthew Daly |
First Address | Sellersville, PA 18960-2958 |
Second Address | Allentown, PA 18102-3508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 30/05/2019 |