Provider Demographics
NPI:1922231489
Name:JOHN R DENTON, M.D. P.C.
Entity Type:Organization
Organization Name:JOHN R DENTON, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DENTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-604-6237
Mailing Address - Street 1:1333A NORTH AVE
Mailing Address - Street 2:BOX 434
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-2120
Mailing Address - Country:US
Mailing Address - Phone:212-604-6237
Mailing Address - Fax:212-604-6723
Practice Address - Street 1:170 W 12TH ST
Practice Address - Street 2:SPELLMAN 7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-6237
Practice Address - Fax:212-604-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102038207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB77745Medicare UPIN