1376670505 NPI number — MS. JULIE M. DALEY RN MS CDE

Table of content: MS. JULIE M. DALEY RN MS CDE (NPI 1376670505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376670505 NPI number — MS. JULIE M. DALEY RN MS CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DALEY
Provider First Name:
JULIE
Provider Middle Name:
M.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN MS CDE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SLOCUM
Provider Other First Name:
JULIE
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN MS CDE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376670505
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
251 CAPRON FARM DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02886-7739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-274-1122
Provider Business Mailing Address Fax Number:
401-459-0108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 DUDLEY ST
Provider Second Line Business Practice Location Address:
WOMEN & INFANTS' HOSPITAL
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02905-2401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-274-1122
Provider Business Practice Location Address Fax Number:
401-159-0108
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WD0400X , with the licence number:  22131 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 405821 . This is a "BLUCHP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 25436-2 . This is a "BLUC CROSSBLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 63-00094 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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