Provider Demographics
NPI:1245651025
Name:DENIS, EMMANUEL DEBOUVARY RHODES (RN)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:DEBOUVARY RHODES
Last Name:DENIS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:EMMANUEL
Other - Middle Name:
Other - Last Name:DENIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2626 HALPERIN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2631
Mailing Address - Country:US
Mailing Address - Phone:718-618-0401
Mailing Address - Fax:347-479-1303
Practice Address - Street 1:2015 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4303
Practice Address - Country:US
Practice Address - Phone:718-583-7736
Practice Address - Fax:718-537-6180
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-23
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308773164W00000X
NYF405572363LP0808X
NY678801163WP0808X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant