Provider Demographics
NPI:1114398195
Name:DENIS MEDICAL PLLC
Entity type:Organization
Organization Name:DENIS MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DENIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-586-4897
Mailing Address - Street 1:341 3RD ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2848
Mailing Address - Country:US
Mailing Address - Phone:732-586-4897
Mailing Address - Fax:
Practice Address - Street 1:341 3RD ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2848
Practice Address - Country:US
Practice Address - Phone:732-586-4897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Single Specialty