Provider Demographics
NPI:1962409391
Name:DENOIA, ANTHONY PHILIP (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:PHILIP
Last Name:DENOIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 STATE ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716
Mailing Address - Country:US
Mailing Address - Phone:732-291-3865
Mailing Address - Fax:732-291-3859
Practice Address - Street 1:1012 STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716
Practice Address - Country:US
Practice Address - Phone:732-291-3865
Practice Address - Fax:732-291-3859
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02763900207R00000X
NJMA027639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D92533Medicare UPIN
NJ1782703Medicare ID - Type UnspecifiedMEDICAID ID
NJ460274CKUMedicare ID - Type UnspecifiedMEDICARE