Healthcare Provider Details

I. General information

NPI: 1679850986
Provider Name (Legal Business Name): MRS. SIMA YAKOBY EPSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SIMA YAKOBY DMD

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BROADWAY SUITE 1707
NEW YORK NY
10006-1901
US

IV. Provider business mailing address

111 BROADWAY SUITE 1707
NEW YORK NY
10006-1901
US

V. Phone/Fax

Practice location:
  • Phone: 212-871-9835
  • Fax: 212-871-9839
Mailing address:
  • Phone: 212-871-9835
  • Fax: 212-871-9839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number050975
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: