Provider Demographics
NPI:1013262955
Name:DENIS, ROSALY J
Entity Type:Individual
Prefix:
First Name:ROSALY
Middle Name:J
Last Name:DENIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SPRINGBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-4423
Mailing Address - Country:US
Mailing Address - Phone:845-406-8793
Mailing Address - Fax:
Practice Address - Street 1:58 ROUTE 59
Practice Address - Street 2:SUITE 1
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3740
Practice Address - Country:US
Practice Address - Phone:845-356-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309165164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse