SAMUEL JOSEPH JR DAISLEY

Debarred entity

Born 13 Jun 1958 (68 years old),United States. Named in 3 sanctions listings.

Screen this subject

Summary

License number: PROMISe#: 001185330

Sanctions and listings3

Effective
19 Jan 2023; 21 Apr 2021
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
pa.gov
Effective
19 Jan 2023
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128b4
Programme US-HHS-OIGoig.hhs.gov oig.hhs.gov
Effective
19 Jan 2023
Official designation
Pennsylvania Department of Human ServicesUS Delaware Medicaid Sanctioned ProvidersUnited States
Federal and MA excluded indefinite
medicaid.dhss.delaware.gov

Positions held1

Period not retained
FAMILY PRACTICE (PHYSICIAN (MD, DO))

Identifiers2

Identifier	Number
ID number	OS006385L
NPI number	1669507505

Other names2

Also known as2

Samuel J Daisley JrSamuel J. Daisley Jr.

Addresses3

11332 KONNEYAUT TRAIL EXT, APT, CONNEAUT LAKE, PA 16316
Mercer, PA
Crawford, PA

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