Provider Demographics
NPI:1326847880
Name:BYAM, DENNIE DANIELLE (ESQ)
Entity type:Individual
Prefix:MS
First Name:DENNIE
Middle Name:DANIELLE
Last Name:BYAM
Suffix:
Gender:
Credentials:ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RELLA BLVD STE 207
Mailing Address - Street 2:#639
Mailing Address - City:MONTEBELLO
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4256
Mailing Address - Country:US
Mailing Address - Phone:914-721-3733
Mailing Address - Fax:
Practice Address - Street 1:1155 WARBURTON AVE APT 7Y
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1019
Practice Address - Country:US
Practice Address - Phone:914-888-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86292257133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered