Individual
DESIREE INEZ DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1630 DEER PARK AVE, DEER PARK, NY 11729-5210
(631) 242-6166
Mailing address
18 CAMPBELL LN, EAST ISLIP, NY 11730-3619
(631) 332-1424
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310456
NY
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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