Provider Demographics
NPI:1982783635
Name:DESONICS, INC
Entity Type:Organization
Organization Name:DESONICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DECHON
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:917-335-2292
Mailing Address - Street 1:249 S MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-3037
Mailing Address - Country:US
Mailing Address - Phone:917-335-2292
Mailing Address - Fax:718-648-2772
Practice Address - Street 1:385 W JOHN ST STE 2
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1033
Practice Address - Country:US
Practice Address - Phone:917-335-2292
Practice Address - Fax:205-922-6272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97Z151Medicare PIN