Provider Demographics
NPI:1720050107
Name:DAYE, MARY C (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:DAYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-1307
Mailing Address - Country:US
Mailing Address - Phone:315-637-5986
Mailing Address - Fax:
Practice Address - Street 1:103 ELECTRONICS PKWY
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-6010
Practice Address - Country:US
Practice Address - Phone:315-457-2141
Practice Address - Fax:315-453-6059
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00648146Medicaid
NY385030Medicare ID - Type Unspecified
NY00648146Medicaid
NY51138QMedicare PIN