Provider Demographics
NPI:1275532202
Name:PINEAU, DENISE C (PT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:C
Last Name:PINEAU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CARTWRIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-3601
Mailing Address - Country:US
Mailing Address - Phone:516-223-5306
Mailing Address - Fax:516-223-5307
Practice Address - Street 1:2280 GRAND AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3164
Practice Address - Country:US
Practice Address - Phone:516-223-5306
Practice Address - Fax:516-223-5307
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
NY4414-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1785331OtherCIGNA-PPO
NYP00000061542OtherGHI MEDICARE
NY6697856OtherGHI
NYHCP1846OtherHIP-HEALTHCARE PARTNERS
NY563146OtherUNITED HEALTHCARE
NYP00278738OtherRAILROAD MEDICARE
NYP51773405OtherMULTIPLAN
NY13929OtherVYTRA
NYHIP004414OtherHIP-ACCESS 1 & 2
NYQ03U11OtherBLUE CROSS
NY11527AOtherMAGNACARE PPO
NY816379OtherTHE EMPIRE PLAN
NY13929OtherVYTRA