Healthcare Provider Details

I. General information

NPI: 1376677658
Provider Name (Legal Business Name): BETH E WASSERMAN HENDLIN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BOULEVARD AVE
CATSKILL NY
12414-1720
US

IV. Provider business mailing address

353 FISHCREEK RD
SAUGERTIES NY
12477-3412
US

V. Phone/Fax

Practice location:
  • Phone: 518-943-9090
  • Fax: 518-943-6853
Mailing address:
  • Phone: 518-943-9090
  • Fax: 518-943-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number040453
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: