Individual
NICOLE DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 HOSPITAL DR, UTICA, NY 13502-2517
(315) 917-9966
(315) 234-3998
Mailing address
111 HOSPITAL DR, UTICA, NY 13502-2517
(315) 801-8534
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
338426
NY
2085R0202X
Diagnostic Radiology Physician
A176854
CA
390200000X
Student in an Organized Health Care Education/Training Program
0116038848
VA
390200000X
Student in an Organized Health Care Education/Training Program
TL.0007572
CO
Other
Enumeration date
03/27/2019
Last updated
08/14/2025
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