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NPI Code Detail

MEDICARE: MARK DACO FNP

MEDICARE: MARK DACO FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner341399NY

General Provider Information

NPI Number : 1184159766
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK DACO FNP
Provider Business Mailing Address
First Line : 134 TERRACE AVE
Second Line :
City : LODI
State : NJ
Zip : 07644-2905
Country : US
Telephone Number : 646-844-7514
Fax Number :
Provider Business Practice Location Address
First Line : 153 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-3108
Country : US
Telephone Number : 929-295-8988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2017
Last Update Date : 10/14/2025

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