Dena Ganoung, RN

Individual provider Active NPI School Registered Nurse · Interlaken, NY

NPI 1700217700 · NPPES record last updated Dec 2, 2013

Key facts

NPI
1700217700
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
434598-1 (NY)
Practice address
8326 Main St
Interlaken, NY 14847-9789
Phone
(607) 869-9636
Fax
(607) 532-8540
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
No

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
434598-1NYMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 434598-1 NY Yes

Addresses

Primary practice location

8326 Main St
Interlaken, NY 14847-9789

Mailing address

8326 Main St
Interlaken, NY 14847-9789
Phone (607) 869-9636

Other providers in Interlaken, NY

All providers in Interlaken, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.