Denise M Gaynor, RN

Individual provider Active NPI Registered Nurse · East Moriches, NY

NPI 1467898379 · NPPES record last updated May 18, 2013

Key facts

NPI
1467898379
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
669798 (NY)
Practice address
491 Montauk Hwy
East Moriches, NY 11940-1376
Phone
(631) 878-6746
NPI assigned
May 18, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
669798NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 669798 NY Yes

Addresses

Primary practice location

491 Montauk Hwy
East Moriches, NY 11940-1376

Mailing address

491 Montauk Hwy
East Moriches, NY 11940-1376
Phone (631) 878-6746

Other providers in East Moriches, NY

All providers in East Moriches, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.