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General NPI Number Information
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NPI Number | 1083218036
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Entity Type | Organization
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Legal Business Name | BROOKLYN PEDIATRIC DENTISTRY PC
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 2522 OCEAN AVE
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City | BROOKLYN
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State | NY
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Zip | 11229-3916
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Country | US
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Telephone | 718-676-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 2522 OCEAN AVE
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City | BROOKLYN
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State | NY
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Zip | 11229-3916
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Country | US
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Telephone | 718-676-2224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALISON ROUMI
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Credential | DDS
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Telephone | 718-676-2224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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