Provider Demographics
NPI:1881027787
Name:DENOYELLES, JOHN (DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DENOYELLES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 STATE ROUTE 17K STE 3
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-2270
Mailing Address - Country:US
Mailing Address - Phone:845-769-7777
Mailing Address - Fax:845-769-0007
Practice Address - Street 1:1128 STATE ROUTE 17K STE 3
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2270
Practice Address - Country:US
Practice Address - Phone:845-769-7777
Practice Address - Fax:845-769-0007
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9889225100000X
NY037761225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist