Healthcare Provider Details

I. General information

NPI: 1659205235
Provider Name (Legal Business Name): HEATHER DACUS DO, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BROADWAY RM 350
MENANDS NY
12204-2893
US

IV. Provider business mailing address

147 EAST AVE
SARATOGA SPRINGS NY
12866-2614
US

V. Phone/Fax

Practice location:
  • Phone: 518-408-5090
  • Fax:
Mailing address:
  • Phone: 518-879-3663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number238474-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: