1710198163 NPI number — DR. DENNIS LOUIS ERRICHIELLO DMD

Table of content: ALANNA MILLER CRNP (NPI 1770988404)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710198163 NPI number — DR. DENNIS LOUIS ERRICHIELLO DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ERRICHIELLO
Provider First Name:
DENNIS
Provider Middle Name:
LOUIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710198163
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 GORGE RD
Provider Second Line Business Mailing Address:
UNIT #54C
Provider Business Mailing Address City Name:
CLIFFSIDE PARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07010-2759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-941-2921
Provider Business Mailing Address Fax Number:
201-941-2921

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 RT. 46 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-361-4200
Provider Business Practice Location Address Fax Number:
973-361-5445
Provider Enumeration Date:
05/25/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  22D101125400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)