Individual ProviderDanielle HatzidakisLicensed Practical NurseNursing Service ProvidersPractice Address15 Glenwood St, East Patchogue, NY 11772-5762(631) 707-5657PECOS EnrollmentBased on the most recent information from CMS, provider Danielle Hatzidakis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1639420193Provider TypeIndividualFull NameHatzidakis, DanielleCredentialLPNGenderFemaleSole ProprietorNoEnumeration Date9/25/2012Last Updated9/25/2012Contact InformationPractice LocationPractice Address15 Glenwood St, East Patchogue, NY 11772-5762Phone(631) 707-5657FaxUnlisted FaxMailing LocationMailing Address15 Glenwood St, East Patchogue, NY 11772-5762Phone(631) 707-5657FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense309244New York