Provider Demographics
NPI:1023018702
Name:YTHIER, DENISE (PA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:YTHIER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BARKER AVE
Mailing Address - Street 2:FL 4
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1509
Mailing Address - Country:US
Mailing Address - Phone:914-949-1199
Mailing Address - Fax:914-949-1245
Practice Address - Street 1:3 BARKER AVE
Practice Address - Street 2:FL 4
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1509
Practice Address - Country:US
Practice Address - Phone:914-949-1199
Practice Address - Fax:914-949-1245
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003280363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01819724Medicaid
NY01819724Medicaid
NYS56964Medicare UPIN