Provider Demographics
NPI:1831287903
Name:CUMMINS, DENNIS P
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:P
Last Name:CUMMINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 ECHO AVE
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764
Mailing Address - Country:US
Mailing Address - Phone:631-331-5353
Mailing Address - Fax:631-331-3948
Practice Address - Street 1:109 ECHO AVE
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764
Practice Address - Country:US
Practice Address - Phone:631-331-5353
Practice Address - Fax:631-331-3948
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0070941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
5802206OtherGHI
928970OtherUNITED HEALTH CARE
928970OtherAMERICAN CHIROPRACTIC NET
1001395OtherAMERICAN SPECIALTY HEALTH
4563831OtherAETNA
804392OtherMANAGED PHYSICAL NETWORK
X61671OtherEMPIRE BCBS
NYX61671Medicare ID - Type Unspecified