Provider Demographics
NPI:1821118779
Name:DENNIS, JAMES HAMILTON JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HAMILTON
Last Name:DENNIS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:DENNIS
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:771 HOAG CHILDES RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-4208
Mailing Address - Country:US
Mailing Address - Phone:607-316-1781
Mailing Address - Fax:
Practice Address - Street 1:409 COUNTY ROAD 33
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-3442
Practice Address - Country:US
Practice Address - Phone:607-316-1781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016243225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist