Healthcare Provider Details

I. General information

NPI: 1891455978
Provider Name (Legal Business Name): DAHLIA S PINDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15722 POWELLS COVE BLVD
BEECHHURST NY
11357-1332
US

IV. Provider business mailing address

13919 34TH RD APT B11
FLUSHING NY
11354-6424
US

V. Phone/Fax

Practice location:
  • Phone: 347-280-3591
  • Fax:
Mailing address:
  • Phone: 646-922-2324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1553843211
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: