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Individual
DR. JACK F DALTON
Active
Individual
DR. JACK F DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
112564
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0041437
GHI
NY
05
—
00881847
—
NY
01
—
113089245
TAX ID
NY
01
—
176007
ELDERPLAN
NY
01
—
24706P
HIP
NY
01
—
4C8348
HEALTHNET
NY
01
—
NS1640
OXFORD HEALTHCARE
NY
Enumeration date
01/26/2006
Last updated
01/11/2011
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