Dacus, Roberta Ann
Dacus, Roberta Ann is an individual health care provider with primary practice located at 530 5Th Ave Fl 10 , New York NY 10036-5114. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dacus, Roberta Ann can be contacted via phone (917) 261-4414.Contact Information
Primary practice address
530 5Th Ave Fl 10
New York NY 10036-5114
Phone: (917) 261-4414
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4704379404 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 20496 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | C-APN.0001472-C-NP | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP30006084 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 348412 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 209.025719 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP107088 | Texas |
Profile Details
| NPI number | 1407835101 |
|---|---|
| LBN Legal business name | Dacus, Roberta Ann |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2006 |
| Last updated | Jul 10th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407835101 | NPPES |
| Other | 154934 | LYI | |
| MEDICAID | 9632647 | LYI |
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