Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 80648 | MA |
NPI | 1013908318 |
---|---|
Provider Name | Mr. Steven J Dakoyannis |
First Address | Revere, MA 02151-3143 |
Second Address | Revere, MA 02151-3143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 19/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3138712 | (05) | MA |
G07652 | (02) |