Provider Demographics
NPI:1467708636
Name:DENARO, EDYTA M (MSSPED)
Entity Type:Individual
Prefix:
First Name:EDYTA
Middle Name:M
Last Name:DENARO
Suffix:
Gender:F
Credentials:MSSPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MARLBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1114
Mailing Address - Country:US
Mailing Address - Phone:516-295-4266
Mailing Address - Fax:718-641-1010
Practice Address - Street 1:405 MARLBOROUGH RD
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1114
Practice Address - Country:US
Practice Address - Phone:516-295-4266
Practice Address - Fax:718-641-1010
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1076901174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist