Individual
DANIELLE HATZIDAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15 GLENWOOD ST, EAST PATCHOGUE, NY 11772-5762
(631) 707-5657
Mailing address
15 GLENWOOD ST, EAST PATCHOGUE, NY 11772-5762
(631) 707-5657
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309244
NY
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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