Provider Demographics
NPI:1699090753
Name:DALY, SUSAN CLAIRE (PA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CLAIRE
Last Name:DALY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 8500-8735
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-8735
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-254-2599
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-3930
Practice Address - Fax:215-456-1432
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2013-03-27
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Provider Licenses
StateLicense IDTaxonomies
PAMA001614L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant