Provider Demographics
NPI:1760485924
Name:DALY, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:DALY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 THOMPSON AVE
Mailing Address - Street 2:LEVEL 3 - COW POD
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-3808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 RUTH ST
Practice Address - Street 2:LEVEL 3 - COW POD
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15211-2384
Practice Address - Country:US
Practice Address - Phone:412-431-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042560E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014128590010Medicaid
PAE73123Medicare UPIN