=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790887123
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VINCENT DENULLY MSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2006
-----------------------------------------------------
Last Update Date | 02/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4200 HUTCHINSON RIVER PKWY E #12C
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10475-4715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-862-1628
-----------------------------------------------------
Fax | 718-862-1628
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4200 HUTCHINSON RIVER PKWY E #12C
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10475-4715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-862-1628
-----------------------------------------------------
Fax | 718-862-1628
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | R043832-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------