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General NPI Number Information
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NPI Number | 1144880295
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Entity Type | Individual
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Provider Name | MRS. OLEKSANDNE VOVKEEN
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Gender | Female
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 1159 BRIGHTON BEACH AVE
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 201-920-7152
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Fax |
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Provider Business Mailing Address
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Address Line | 211 CONIFER CREST WAY
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City | EATONTOWN
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State | NJ
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Zip | 07724
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Country | US
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Telephone | 646-724-5719
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 22HI01105000
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License Number State | NJ
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