Healthcare Provider Details

I. General information

NPI: 1306053657
Provider Name (Legal Business Name): JOANNE LAURA DALY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 HIGHRIDGE ROAD
BELLINGHAM MA
02019-1869
US

IV. Provider business mailing address

19 HIGHRIDGE RD
BELLINGHAM MA
02019-1869
US

V. Phone/Fax

Practice location:
  • Phone: 508-359-6855
  • Fax: 508-359-7519
Mailing address:
  • Phone: 508-359-6855
  • Fax: 508-359-7519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25697
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: