Provider Demographics
NPI:1760011910
Name:DALMEUS, PRESNEL JR
Entity Type:Individual
Prefix:
First Name:PRESNEL
Middle Name:
Last Name:DALMEUS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HEALTH SCIENCES DR
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3337
Mailing Address - Country:US
Mailing Address - Phone:845-300-4379
Mailing Address - Fax:
Practice Address - Street 1:700 HEALTH SCIENCES DR
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3337
Practice Address - Country:US
Practice Address - Phone:845-300-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYHJVJY.HV2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine