MEDICARE: DR. STELLA ALEKSENBERG-SCHWARTZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	050410	NY

General Provider Information

NPI Number	:	1629180096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STELLA ALEKSENBERG-SCHWARTZ DDS

Provider Business Mailing Address
First Line	:	1432 FOREST AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10302-2204
Country	:	US
Telephone Number	:	718-442-9254
Fax Number	:	718-720-9107

Provider Business Practice Location Address
First Line	:	1432 FOREST AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10302-2204
Country	:	US
Telephone Number	:	718-442-9254
Fax Number	:	718-720-9107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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