Doctor Name: | DENA GANOUNG |
NPI Number: | 1700217700 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 434598-1 |
Business Practice Address: | 8326 Main St Interlaken, NY - 148479789 |
Business Phone Number: | 6078699636 |
Business Fax Number: | 6075328540 |
Mailing Address: | 8326 Main St, INTERLAKEN |
State: | NY |
Postal Code: | 148479789 |
Phone Number: | 6078699636 |
Fax Number: | 6075328540 |
NPI Enumeration Date: | 12/02/2013 |
NPI Last Update Date: | 12/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 434598-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |