Provider Demographics
NPI:1184977035
Name:DENNIS, ANN MARIE M (MSED)
Entity type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:M
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ERSKINE PL
Mailing Address - Street 2:13D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-5702
Mailing Address - Country:US
Mailing Address - Phone:646-646-2624
Mailing Address - Fax:
Practice Address - Street 1:120 ERSKINE PL
Practice Address - Street 2:13D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-5702
Practice Address - Country:US
Practice Address - Phone:646-646-2624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2305552174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2305552OtherTEACHER CERTIFICATION