Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Timothy Richard Dackow, NURSEPRACTITIONER

Individual provider Adult Health Nurse Practitioner · NPI 1144700741

Mr. Timothy Richard Dackow, NURSEPRACTITIONER is a Nurse Practitioner in East Moriches, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 2018, 8 years ago. Practices with Stony Brook Internists University Faculty Practice Corporation, a 428-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2018

Practice location Address checks out

7 Newpoint Ln
East Moriches, NY 11940-1565
Phone: (516) 322-8850
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F3088261 (NY)

Record details

NPI number1144700741
Entity typeIndividual (Type 1)
GenderMale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedAugust 14, 2018
Last updated in NPPESAugust 14, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Stony Brook Internists University Faculty Practice Corporation — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in East Moriches