Provider Demographics
NPI:1154090108
Name:DENBY, DIASHA
Entity Type:Individual
Prefix:
First Name:DIASHA
Middle Name:
Last Name:DENBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 BEAVER ST APT G12
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2029
Mailing Address - Country:US
Mailing Address - Phone:203-533-1809
Mailing Address - Fax:
Practice Address - Street 1:477 BEAVER ST APT G12
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-2029
Practice Address - Country:US
Practice Address - Phone:203-533-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-12
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide