Provider Demographics
NPI:1821149303
Name:MCNABB, DENNIS PAUL (MSW)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:PAUL
Last Name:MCNABB
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 WOOLEYS LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2328
Mailing Address - Country:US
Mailing Address - Phone:516-466-7363
Mailing Address - Fax:
Practice Address - Street 1:81 WOOLEYS LN
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2328
Practice Address - Country:US
Practice Address - Phone:516-466-7363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR015621-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN11141Medicare ID - Type Unspecified