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Individual

DR. DENNIS MICHAEL ILLUZZI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
61 ROUTE 111, SMITHTOWN, NY 11787-3712
(631) 360-7733
(631) 360-7786
Mailing address
315 OLD MILL RD, NISSEQUOGUE, NY 11780-4206
(631) 724-4959
(631) 724-4959

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004192
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00994972
NY
Enumeration date
02/26/2006
Last updated
04/25/2012
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