Provider Demographics
NPI:1205202223
Name:HACKNEY, DENNIS JR
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:HACKNEY
Suffix:JR
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 1:215 W TOWN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2130
Mailing Address - Country:US
Mailing Address - Phone:860-949-8350
Mailing Address - Fax:860-326-5723
Practice Address - Street 1:215 W TOWN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2130
Practice Address - Country:US
Practice Address - Phone:860-949-8350
Practice Address - Fax:860-326-5723
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT439237700000X
TX80304237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist