Provider Demographics
NPI:1760498836
Name:DENNEHY, DANIEL T (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:DENNEHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 CENTER ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4100
Mailing Address - Country:US
Mailing Address - Phone:203-284-1060
Mailing Address - Fax:203-284-3161
Practice Address - Street 1:185 CENTER ST
Practice Address - Street 2:SUITE H
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-4100
Practice Address - Country:US
Practice Address - Phone:203-284-1060
Practice Address - Fax:203-284-3161
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037723207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001377234Medicaid
CTG93689Medicare UPIN
CT001377234Medicaid