Provider Demographics
NPI:1467850115
Name:DENAUT, NEIL II
Entity type:Individual
Prefix:MR
First Name:NEIL
Middle Name:
Last Name:DENAUT
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9653 CARLTON HILLS BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-1463
Mailing Address - Country:US
Mailing Address - Phone:845-661-3044
Mailing Address - Fax:
Practice Address - Street 1:9653 CARLTON HILLS BLVD APT 4
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-1463
Practice Address - Country:US
Practice Address - Phone:845-661-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist