Individual
DYLAN O'ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R-PAC
Contact information
Practice address
81 N BROADWAY, HICKSVILLE, NY 11801-2920
(516) 933-4350
(516) 933-4352
Mailing address
81 N BROADWAY, HICKSVILLE, NY 11801-2920
(516) 933-4350
(516) 933-4352
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008867
NY
363AM0700X
Medical Physician Assistant
008867
NY
Other
Enumeration date
08/18/2005
Last updated
11/12/2019
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