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David Jonathan Dagate

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NPI Number Detailed Information

Provider Information:

Name: David Jonathan Dagate
Gender: M
Provider License Number If Given: 224912-1

NPI Information:

NPI: 1790784395
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 4/17/2008

Provider Business Mailing Address:

Address: 260 MIDDLE COUNTRY RD SUITE 214
Smithtown, NY 11787
Phone Number: 6312655050
Fax Number: 6312653304

Provider Business Practice Location Address:

Address: 260 MIDDLE COUNTRY RD SUITE 214
Smithtown, NY 11787
Phone Number: 6312655050
Fax Number: 6312653304

Provider Taxonomy:

Primary: 174400000X
Secondary (if any):
State: NY

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