Healthcare Provider Details

I. General information

NPI: 1609002328
Provider Name (Legal Business Name): HELEN PLIAKAS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 77TH ST APT 9A
NEW YORK NY
10075-2303
US

IV. Provider business mailing address

400 E 77TH ST APT 9A
NEW YORK NY
10075-2303
US

V. Phone/Fax

Practice location:
  • Phone: 212-879-0375
  • Fax:
Mailing address:
  • Phone: 212-879-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number049960-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: