Healthcare Provider Details

I. General information

NPI: 1427892678
Provider Name (Legal Business Name): CHOICE CARDIOVASCULAR GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2024
Last Update Date: 06/22/2024
Certification Date: 06/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 S MAIN ST
MIDDLETON MA
01949-2446
US

IV. Provider business mailing address

147 S MAIN ST
MIDDLETON MA
01949-2446
US

V. Phone/Fax

Practice location:
  • Phone: 339-242-7465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GERARD H DALY
Title or Position: CARDIOLOGIST
Credential: MD, MS
Phone: 339-242-7465