NPI Profile for TIMOTHY R DACKOW in EAST MORICHES, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Health |
363LA2200X | 50 | Nurse Practitioner |
| NPI # | 1144700741 |
|
| Status | Active | |
| Credentials | NURSE PRACTITIONER | |
| Entity | Individual | |
| Enumeration date | 08/14/2018 | |
| Last updated | 08/14/2018 - About 8 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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TIMOTHY R DACKOW
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