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Individual
THOMAS J DALEY
Active
Individual
THOMAS J DALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-R
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
040053
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03004280
MEDICAID AGENCY
NY
01
—
400201096001
CDPHP
NY
01
—
53415A
MEDICARE AGENCY PIN
NY
Enumeration date
12/22/2005
Last updated
11/02/2016
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