Healthcare Provider Details

I. General information

NPI: 1497296412
Provider Name (Legal Business Name): HARVEY MICHAEL CHOIT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 HICKSVILLE RD
BETHPAGE NY
11714-3445
US

IV. Provider business mailing address

99 HICKSVILLE RD
BETHPAGE NY
11714-3445
US

V. Phone/Fax

Practice location:
  • Phone: 516-579-8950
  • Fax: 516-579-0092
Mailing address:
  • Phone: 516-579-8950
  • Fax: 516-579-0092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number034155
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: