MEDICARE: MRS. PATRICIA DALY LCSW

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
1	1041C0700X	Clinical Social Worker	SC00269600	NJ

General Provider Information

NPI Number	:	1982780516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA DALY LCSW

Provider Business Mailing Address
First Line	:	723 HUMBOLDT ST
Second Line	:
City	:	SECAUCUS
State	:	NJ
Zip	:	07094-3217
Country	:	US
Telephone Number	:	201-867-5938
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-3582
Country	:	US
Telephone Number	:	201-558-3724
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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