Individual
DANIELLE DACRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 BANK AVE, SMITHTOWN, NY 11787-2703
(631) 265-5300
Mailing address
86 CEDAR LN, MEDFORD, NY 11763-1173
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
327363-1
NY
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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