| NPI | 1255701959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALYA KOROBEYNYK Rcm 516-654-4400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 037989) |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist, Endodontics (Licence: NY 055531) | |
| 1223G0001X Dentist, General Practice (Licence: NY 042857) | |
| 1223G0001X Dentist, General Practice (Licence: NY 057838) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 053382) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055400) | |
| 1223P0700X Dentist, Prosthodontics (Licence: NY 037623) | |
| 1223P0700X Dentist, Prosthodontics (Licence: NY 043834) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 036753) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 049846) | |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2021-12-13 |