Provider Demographics
NPI:1679501464
Name:DENENBERG, ALLAN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:CHARLES
Last Name:DENENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:35 WEST MAIN ST
Mailing Address - Street 2:SUITE204
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-625-9596
Mailing Address - Fax:973-625-1713
Practice Address - Street 1:35 WEST MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-625-9596
Practice Address - Fax:973-625-1713
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2010-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ21354207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ157812Medicare ID - Type Unspecified
C53641Medicare UPIN