Healthcare Provider Details

I. General information

NPI: 1194929851
Provider Name (Legal Business Name): GABRIELA HRICKO D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MADISON AVE SUITE 3900
NEW YORK NY
10022-5403
US

IV. Provider business mailing address

357 BRITTANY FARMS RD #339
NEW BRITAIN CT
06053-1102
US

V. Phone/Fax

Practice location:
  • Phone: 212-935-9300
  • Fax:
Mailing address:
  • Phone: 917-734-5053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number050414
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: