Skip Navigation

Provider Information for 1144492687



GENNADIY KRAVETS D.M.D.

Gender: MALE

Individual NPI: 1144492687

Calendar Last Updated: 2008-03-25

Details

Name Value
NPI 1144492687
Enumeration Date 2008-03-25
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 202 UNION AVE SUITE D
BROOKLYN, NY 11211-7467
United States

Phone: 718-388-4613 | Fax: 718-388-4613
View Map External Link
Primary Practice Address 202 UNION AVE SUITE D
BROOKLYN, NY 11211-7467
United States

Phone: 718-388-4613 | Fax: 718-388-4613
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NY 02721328
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist NY 052594-1