Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 265688 | MA |
Y | 111NI0900X | Internist | 265688 | MA |
NPI | 1003179599 |
---|---|
Provider Name | Gerard Daly |
First Address | Burlington, MA 01805-0001 |
Second Address | Burlington, MA 01805-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 06/06/2016 |