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NPI Code Detail

MEDICARE: THOMAS GORDON DALY PT, DPT

MEDICARE: THOMAS GORDON DALY PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT032019PA

General Provider Information

NPI Number : 1841982659
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS GORDON DALY PT, DPT
Provider Business Mailing Address
First Line : PO BOX 411503
Second Line :
City : BOSTON
State : MA
Zip : 02241-1503
Country : US
Telephone Number : 914-294-4050
Fax Number :
Provider Business Practice Location Address
First Line : 1714 FAIRMOUNT AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-2812
Country : US
Telephone Number : 267-606-6923
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2023
Last Update Date : 02/07/2024

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