Provider Demographics
NPI:1992422760
Name:QUAY, DANIEL ALBERT
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALBERT
Last Name:QUAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18578 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-6215
Mailing Address - Country:US
Mailing Address - Phone:302-644-1903
Mailing Address - Fax:
Practice Address - Street 1:18578 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-6215
Practice Address - Country:US
Practice Address - Phone:302-644-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAI-0015803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist