Healthcare Provider Details

I. General information

NPI: 1871900415
Provider Name (Legal Business Name): VANESSA FIGUEROA RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2014
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 METROPOLITAN AVE SUITE 6D
BRONX NY
10462-6964
US

IV. Provider business mailing address

1700 METROPOLITAN AVE SUITE 6D
BRONX NY
10462-6964
US

V. Phone/Fax

Practice location:
  • Phone: 347-739-7081
  • Fax:
Mailing address:
  • Phone: 347-739-7081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number023499-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: