Healthcare Provider Details

I. General information

NPI: 1215779541
Provider Name (Legal Business Name): CATALINA DAILEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4104 VESTAL RD STE 203
VESTAL NY
13850-3500
US

IV. Provider business mailing address

3413 ALMAR DR
VESTAL NY
13850-2838
US

V. Phone/Fax

Practice location:
  • Phone: 607-202-4850
  • Fax: 607-202-4859
Mailing address:
  • Phone: 607-235-6896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF354361-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF354361-01
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberF354361-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: