Provider Demographics
NPI:1821223694
Name:DENNISON, BARBARA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANNE
Last Name:DENNISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ST DAVIDS LN
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-4822
Mailing Address - Country:US
Mailing Address - Phone:518-473-4438
Mailing Address - Fax:518-473-2853
Practice Address - Street 1:EMPIRE STATE PLZ
Practice Address - Street 2:CORNING TOWER, RM 1042
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12223-1551
Practice Address - Country:US
Practice Address - Phone:518-474-0512
Practice Address - Fax:518-473-2853
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175125208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics