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Individual

RICHARD ANTHONY DENTICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1910 SOUTH RD, POUGHKEEPSIE, NY 12601-6027
(845) 454-0120
(845) 454-6080
Mailing address
1910 SOUTH RD, POUGHKEEPSIE, NY 12601-6027
(845) 454-0120
(845) 454-6080

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
252207
NY
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
252207
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03110969
NY
Enumeration date
03/23/2009
Last updated
01/23/2014
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