Healthcare Provider Details

I. General information

NPI: 1285334110
Provider Name (Legal Business Name): SNEHA KURIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 WICKHAM AVE
MIDDLETOWN NY
10940-3714
US

IV. Provider business mailing address

622 W 168TH ST
NEW YORK NY
10032-3720
US

V. Phone/Fax

Practice location:
  • Phone: 845-343-9919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number064927-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: