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Provider Information for 1669566444

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1669566444

Calendar   Last Updated:  2007-07-08
  Certification Date: 


Name Value
NPI 1669566444
Enumeration Date 2006-10-03
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 8635 CHELSEA ST
JAMAICA, NY 11432-2436
United States

Phone: 718-701-1442 | Fax:
View Map External Link
Primary Practice Address 8835 164TH ST APT DN
JAMAICA, NY 11432-4003
United States

Phone: 718-291-6871 | Fax: 718-291-7362
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NY 045635-1