Provider Demographics
NPI:1285856880
Name:DENISI, DOMINICK JOHN (DC)
Entity type:Individual
Prefix:MR
First Name:DOMINICK
Middle Name:JOHN
Last Name:DENISI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5152 RT 9W
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1415
Mailing Address - Country:US
Mailing Address - Phone:845-565-8542
Mailing Address - Fax:845-565-8542
Practice Address - Street 1:5152 RT 9W
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1415
Practice Address - Country:US
Practice Address - Phone:845-565-8542
Practice Address - Fax:845-565-8542
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0031871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX18181Medicare ID - Type Unspecified