Provider Demographics
NPI:1124281712
Name:DENNISON WE
Entity type:Organization
Organization Name:DENNISON WE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIITONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNISON
Authorized Official - Middle Name:
Authorized Official - Last Name:WE
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:1718-670-2636
Mailing Address - Street 1:306 CLEMENT AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3434
Mailing Address - Country:US
Mailing Address - Phone:516-502-6798
Mailing Address - Fax:
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:516-670-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304435282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital