Healthcare Provider Details

I. General information

NPI: 1972031441
Provider Name (Legal Business Name): SHAY MARKOVITCH DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 ROUTE 9 STE 209
WAPPINGERS FALLS NY
12590-4977
US

IV. Provider business mailing address

1323 ROUTE 9 STE 209
WAPPINGERS FALLS NY
12590-4977
US

V. Phone/Fax

Practice location:
  • Phone: 845-297-0757
  • Fax: 845-297-0106
Mailing address:
  • Phone: 845-297-0757
  • Fax: 845-297-0106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number054658
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH WORTHMAN
Title or Position: REGIONAL MANAGER
Credential:
Phone: 845-297-0757