Healthcare Provider Details

I. General information

NPI: 1396981148
Provider Name (Legal Business Name): ZIPPORAH DALEY R.N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 BROADWAY APT:1
BROOKLYN NY
11207-1611
US

IV. Provider business mailing address

1770 BROADWAY APT:1
BROOKLYN NY
11207-1611
US

V. Phone/Fax

Practice location:
  • Phone: 718-919-5596
  • Fax: 718-919-5596
Mailing address:
  • Phone: 718-919-5596
  • Fax: 718-919-5596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number358576-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: