Provider Demographics
NPI:1770588378
Name:ALBANO, DENISE A (ANPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:ALBANO
Suffix:
Gender:F
Credentials:ANPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 N BELLE MEAD RD
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3456
Mailing Address - Country:US
Mailing Address - Phone:631-751-3000
Mailing Address - Fax:631-751-3366
Practice Address - Street 1:235 N BELLE MEAD RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3456
Practice Address - Country:US
Practice Address - Phone:631-751-3000
Practice Address - Fax:631-751-3366
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302538363LA2200X
NC9600447164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02242102Medicaid
NYP00153714OtherRR MEDICARE
NY02242102Medicaid
NY96N381Medicare PIN