Provider Demographics
NPI:1821065293
Name:DENENBERG, BARRY S (MD)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:S
Last Name:DENENBERG
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 1:16704 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4929
Mailing Address - Country:US
Mailing Address - Phone:302-645-1233
Mailing Address - Fax:302-645-1228
Practice Address - Street 1:16704 KINGS HWY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4929
Practice Address - Country:US
Practice Address - Phone:302-645-1233
Practice Address - Fax:302-645-1228
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1002770207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000127501Medicaid
DE025671C16Medicare ID - Type Unspecified
DE0000127501Medicaid