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General NPI Number Information
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NPI Number | 1871972737
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Entity Type | Individual
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Provider Name | DENISSE INOA MD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 8340 WOODHAVEN BLVD
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City | GLENDALE
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State | NY
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Zip | 11385-7824
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Country | US
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Telephone | 718-850-4368
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Fax |
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Provider Business Mailing Address
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Address Line | 8308 125TH ST
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City | KEW GARDENS
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State | NY
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Zip | 11415-2706
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Country | US
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Telephone | 646-341-2915
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 287041
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License Number State | NY
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