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General NPI Number Information
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NPI Number | 1124280094
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Entity Type | Individual
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Provider Name | DUCREPIN FLEURINORD DDS
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Gender | Male
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 360 W 125TH ST STE 7A
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City | NEW YORK
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State | NY
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Zip | 10027-4801
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Country | US
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Telephone | 202-222-8853
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RIVER PL APT 1802
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City | NEW YORK
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State | NY
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Zip | 10036-4373
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Country | US
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Telephone | 202-222-8853
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 054427
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License Number State | NY
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