MEDICARE: DALEY HOME CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1063040210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALEY HOME CARE, LLC

Provider Business Mailing Address
First Line	:	56 VAN PELT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-2407
Country	:	US
Telephone Number	:	646-474-3327
Fax Number	:	347-855-2964

Provider Business Practice Location Address
First Line	:	56 VAN PELT AVE APT 2
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-2407
Country	:	US
Telephone Number	:	646-474-3327
Fax Number	:	347-855-2964

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. VERONICA DALEY
Credential	:
Telephone Number	:	646-474-3327

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	11/13/2020

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