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General NPI Number Information
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NPI Number | 1093848624
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Entity Type | Organization
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Legal Business Name | PROSTHODONTIC ASSOCIATES OF NY, PC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 60 E 42ND ST SUITE 1656
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City | NEW YORK
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State | NY
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Zip | 10165-0006
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Country | US
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Telephone | 212-986-4839
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Fax | 212-986-4927
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Provider Business Mailing Address
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Address Line | 60 E 42ND ST SUITE 1656
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City | NEW YORK
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State | NY
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Zip | 10165-0006
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Country | US
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Telephone | 212-986-4839
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Fax | 212-986-4927
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOEL GOLDIN
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Credential | DMD
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Telephone | 212-986-4830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 023996
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License Number State | NY
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