Provider Demographics
NPI:1467707083
Name:DENGEL, KARRIANN S
Entity Type:Individual
Prefix:
First Name:KARRIANN
Middle Name:S
Last Name:DENGEL
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 1:345 RICHMOND LN
Mailing Address - Street 2:
Mailing Address - City:PECONIC
Mailing Address - State:NY
Mailing Address - Zip Code:11958-1747
Mailing Address - Country:US
Mailing Address - Phone:631-734-7751
Mailing Address - Fax:
Practice Address - Street 1:345 RICHMOND LN
Practice Address - Street 2:
Practice Address - City:PECONIC
Practice Address - State:NY
Practice Address - Zip Code:11958-1747
Practice Address - Country:US
Practice Address - Phone:631-734-7751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist