Individual
DR. EDWARD DENEVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5 BELLPORT LN, BELLPORT, NY 11713-2705
(631) 286-4014
Mailing address
5 BELLPORT LN, BELLPORT, NY 11713-2705
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6097TUV
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157939
PROVIDER
NY
01
—
163
PROVIDER
NY
01
—
50593
PROVIDER
NY
01
—
66599326
PROVIDER
NY
01
—
7182561
PROVIDER
NY
01
—
864
STORE
NY
01
—
V73
STORE
NY
Enumeration date
01/04/2007
Last updated
07/08/2007
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