Provider Demographics
NPI:1427434299
Name:DE JESUS, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DE JESUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 FULTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3907
Mailing Address - Country:US
Mailing Address - Phone:516-538-2613
Mailing Address - Fax:516-538-0772
Practice Address - Street 1:344 FULTON AVENUE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3907
Practice Address - Country:US
Practice Address - Phone:516-538-2613
Practice Address - Fax:516-538-0772
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health