Provider Demographics
NPI:1942947486
Name:DENNE, DJANGO PETER (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DJANGO
Middle Name:PETER
Last Name:DENNE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 LANDON HILL RD, POBOX 288
Mailing Address - Street 2:
Mailing Address - City:POTTERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12860
Mailing Address - Country:US
Mailing Address - Phone:518-307-5251
Mailing Address - Fax:
Practice Address - Street 1:1062 LANDON HILL RD
Practice Address - Street 2:
Practice Address - City:POTTERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12860
Practice Address - Country:US
Practice Address - Phone:518-307-5251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT6149225100000X
NY048255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist