Provider Demographics
NPI:1457935843
Name:ESIKOFF, DANIEL ALEXANDER (LMSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALEXANDER
Last Name:ESIKOFF
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-0430
Mailing Address - Country:US
Mailing Address - Phone:651-402-9486
Mailing Address - Fax:
Practice Address - Street 1:50 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1398
Practice Address - Country:US
Practice Address - Phone:631-862-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker