Provider Demographics
NPI:1114198967
Name:DENNIS EGITTO MD PA
Entity Type:Organization
Organization Name:DENNIS EGITTO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:EGITTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-622-4326
Mailing Address - Street 1:860 US HIGHWAY 1
Mailing Address - Street 2:STE 103
Mailing Address - City:N PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3879
Mailing Address - Country:US
Mailing Address - Phone:561-622-4326
Mailing Address - Fax:
Practice Address - Street 1:860 US HIGHWAY 1
Practice Address - Street 2:STE 103
Practice Address - City:N PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3825
Practice Address - Country:US
Practice Address - Phone:561-622-4326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL037622207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN
FL=========OtherEIN
FL61169Medicare PIN