Healthcare Provider Details

I. General information

NPI: 1235972845
Provider Name (Legal Business Name): ANDREA NEDA NAZARI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 N 8TH ST
BROOKLYN NY
11249-2007
US

IV. Provider business mailing address

144 N 8TH ST GROUND FLOOR
BROOKLYN NY
11249-2007
US

V. Phone/Fax

Practice location:
  • Phone: 914-875-3255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number065053
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: