Provider Demographics
NPI:1134308166
Name:DENNIS & CONNOLLY, D.P.M., PLLC
Entity Type:Organization
Organization Name:DENNIS & CONNOLLY, D.P.M., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:N
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-921-1668
Mailing Address - Street 1:150 PURCHASE ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2141
Mailing Address - Country:US
Mailing Address - Phone:914-921-1668
Mailing Address - Fax:914-967-5887
Practice Address - Street 1:150 PURCHASE ST
Practice Address - Street 2:SUITE 5
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2141
Practice Address - Country:US
Practice Address - Phone:914-921-1668
Practice Address - Fax:914-967-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PNW391Medicare PIN