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Individual

MR. DANIEL THOMAS DENNIS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
301 PROSPECT AVE, PCC-MAIN, POB 6TH FLOOR, SYRACUSE, NY 13203-1807
(315) 448-5491
(315) 448-6203
Mailing address
301 PROSPECT AVE, PCC-MAIN, POB 6TH FLOOR, SYRACUSE, NY 13203-1807
(315) 448-5491
(315) 448-6203

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
340652
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F340652-1
NEW YORK STATE LICENSE NUMBER
NY
Enumeration date
06/16/2016
Last updated
05/08/2024
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