Healthcare Provider Details

I. General information

NPI: 1952965329
Provider Name (Legal Business Name): SARAH DALY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PARKER HILL AVE # MAIN2
BOSTON MA
02120-2847
US

IV. Provider business mailing address

58 ASH ST UNIT 4
WALTHAM MA
02453-3995
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-5500
  • Fax:
Mailing address:
  • Phone: 773-480-3304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number23453
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: