Skip Navigation

Provider Information for 1689947848

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

COREY RUSSELL BRICK D.D.S.

Gender: MALE

Individual NPI: 1689947848

Calendar   Last Updated:  2013-10-02
  Certification Date: 

Details

Name Value
NPI 1689947848
Enumeration Date 2012-02-20
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 245 E. 63RD ST. SUITE #110
NEW YORK, NY 10065
United States

Phone: 212-838-6226 | Fax:
View Map External Link
Primary Practice Address 245 E. 63RD ST. SUITE #110
NEW YORK, NY 10065
United States

Phone: 212-838-6226 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist NY 056826