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General NPI Number Information
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NPI Number | 1962052589
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Entity Type | Organization
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Legal Business Name | DR RICHARD J DACKOW PSYCHOLOGY SERVICES
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 01/22/2023
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Provider Practice Location Address
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Address Line | 15 DONALD ST
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City | EASTPORT
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State | NY
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Zip | 11941-1401
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Country | US
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Telephone | 516-330-4545
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Fax | 516-654-8870
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Provider Business Mailing Address
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Address Line | 15 DONALD ST
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City | EASTPORT
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State | NY
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Zip | 11941-1401
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Country | US
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Telephone | 516-330-4545
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Fax | 516-654-8870
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LINDA DACKOW
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Credential |
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Telephone | 631-288-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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