Provider Demographics
NPI:1619183035
Name:DACUYCUY, MARY ABIGAIL C (MD)
Entity Type:Individual
Prefix:
First Name:MARY ABIGAIL
Middle Name:C
Last Name:DACUYCUY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1327
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:15 AIKEN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-1259
Practice Address - Country:US
Practice Address - Phone:603-934-6562
Practice Address - Fax:603-934-4298
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2012-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH13337207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease