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NPI Code Detail

MEDICARE: VICTORIA MARYANSKY D.D.S

MEDICARE: VICTORIA MARYANSKY D.D.S
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
11223G0001XGeneral Practice Dentistry049687NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780751446
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA MARYANSKY D.D.S
Provider Business Mailing Address
First Line : 260 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-5940
Country : US
Telephone Number : 718-336-8855
Fax Number : 718-336-4366
Provider Business Practice Location Address
First Line : 260 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-5940
Country : US
Telephone Number : 718-336-8855
Fax Number : 718-336-4366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 07/09/2007

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