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General NPI Number Information
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NPI Number | 1124395033
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Entity Type | Organization
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Legal Business Name | RIVSON DENTAL PC
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Dates
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Enumeration Date | 11/20/2011
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Last Update Date | 11/20/2011
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Provider Practice Location Address
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Address Line | 216 E 39TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-2738
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Country | US
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Telephone | 646-861-3070
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Fax | 646-861-2980
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Provider Business Mailing Address
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Address Line | 216 E 39TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-2738
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Country | US
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Telephone | 646-861-3070
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Fax | 646-861-2980
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIMON SHEINKMAN
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Credential | D.D.S
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Telephone | 646-861-3070
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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 | 039106
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License Number State | NY
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