Healthcare Provider Details

I. General information

NPI: 1710057633
Provider Name (Legal Business Name): IOHANA A. ASMARANDEI D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137-50 JAMAICA AVE
JAMAICA NY
11435-3610
US

IV. Provider business mailing address

199-34 KENO AVE
JAMAICA NY
11423-1434
US

V. Phone/Fax

Practice location:
  • Phone: 718-298-5100
  • Fax: 718-298-5130
Mailing address:
  • Phone: 718-468-3047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number050842-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: