Provider Demographics
NPI:1588139984
Name:DENYSOVA, OLENA (FNP)
Entity type:Individual
Prefix:MISS
First Name:OLENA
Middle Name:
Last Name:DENYSOVA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 HOMECREST AVE APT 4V
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4543
Mailing Address - Country:US
Mailing Address - Phone:646-725-9585
Mailing Address - Fax:
Practice Address - Street 1:11129 QUEENS BLVD # 1
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5553
Practice Address - Country:US
Practice Address - Phone:164-672-5958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF343413363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty