Provider Demographics
NPI:1326123316
Name:DENYSENKO, JENNIFER KRISTIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KRISTIE
Last Name:DENYSENKO
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 1:12 WISTERIA LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-1472
Mailing Address - Country:US
Mailing Address - Phone:585-266-1582
Mailing Address - Fax:
Practice Address - Street 1:12 WISTERIA LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-1472
Practice Address - Country:US
Practice Address - Phone:585-266-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016238-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist