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General NPI Number Information
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NPI Number | 1104284835
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Entity Type | Individual
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Provider Name | IVAN DENKER
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Gender | Male
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 4510 FRANKFORD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19124-3602
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Country | US
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Telephone | 215-744-1302
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Fax | 215-744-2544
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Provider Business Mailing Address
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Address Line | 432 N 6TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19123-4004
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Country | US
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Telephone | 215-925-2400
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Fax | 215-925-9162
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN663483
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR17659800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 22 710754
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP015880
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 33 340355
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License Number State | NY
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