Provider Demographics
NPI:1699742403
Name:WHITTAM, DENISE M (OD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:M
Last Name:WHITTAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:500 LEXINGTON AVE
Mailing Address - Street 2:COHENS FASHION OPTICAL OF 47TH ST
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-697-9299
Mailing Address - Fax:212-697-8872
Practice Address - Street 1:500 LEXINGTON AVE
Practice Address - Street 2:COHENS FASHION OPTICAL OF 47TH ST
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-697-9299
Practice Address - Fax:212-697-8872
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYTUV005247152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist