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Individual
ESTHER TACKIE
Active
Individual
ESTHER TACKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
240897
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02127466
—
NY
Enumeration date
10/14/2008
Last updated
10/14/2008
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