Provider Demographics
NPI:1023530581
Name:VAN DENAKKER, TAYLER ASHLEE (MD)
Entity type:Individual
Prefix:
First Name:TAYLER
Middle Name:ASHLEE
Last Name:VAN DENAKKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 AMSTERDAM AVE # CLARK4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1716
Mailing Address - Country:US
Mailing Address - Phone:917-856-8434
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE # CLARK4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-4526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-16
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211224039207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology