Provider Demographics
NPI:1588814701
Name:CIRILLA, DENNIS JACOB II (DO)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JACOB
Last Name:CIRILLA
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:PROF
Other - First Name:DENNIS
Other - Middle Name:JACOB
Other - Last Name:CIRILLA
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1346 STERLING RD
Mailing Address - Street 2:
Mailing Address - City:PATTERSONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12137-2513
Mailing Address - Country:US
Mailing Address - Phone:518-424-2784
Mailing Address - Fax:518-887-2218
Practice Address - Street 1:1346 STERLING RD
Practice Address - Street 2:
Practice Address - City:PATTERSONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12137-2513
Practice Address - Country:US
Practice Address - Phone:518-424-2784
Practice Address - Fax:518-887-2218
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252666207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY62359OtherALBANY MEDICAL CENTER