Provider Demographics
NPI:1093039026
Name:O'GRADY, DENNIS RONALD
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:RONALD
Last Name:O'GRADY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WILLIAM ST
Mailing Address - Street 2:APT 1
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-1417
Mailing Address - Country:US
Mailing Address - Phone:518-943-5089
Mailing Address - Fax:
Practice Address - Street 1:45 WILLIAM ST
Practice Address - Street 2:APT 1
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1417
Practice Address - Country:US
Practice Address - Phone:518-943-5089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist