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General NPI Number Information
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NPI Number | 1174142749
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Entity Type | Organization
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Legal Business Name | REBECCAJBINDER
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 551 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10176-0001
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Country | US
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Telephone | 212-753-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 551 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10176-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | YVONNE DICKERSON
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Credential |
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Telephone | 951-609-8518
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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 |
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License Number State |
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