Provider Demographics
NPI:1902087562
Name:LIOTTA, DENNIS B (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:B
Last Name:LIOTTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WATER STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-8190
Mailing Address - Country:US
Mailing Address - Phone:646-447-7615
Mailing Address - Fax:
Practice Address - Street 1:55 WATER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10041-0004
Practice Address - Country:US
Practice Address - Phone:646-447-7615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153452-1207R00000X
NJ25MA04372900207R00000X
FLME97204207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine