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General NPI Number Information
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NPI Number | 1215082946
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Entity Type | Individual
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Provider Name | ELLEN J. HEUMAN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 842 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 212-327-0576
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Fax | 212-737-0696
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Provider Business Mailing Address
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Address Line | 1175 PARK AVE APARTMENT 5A-1
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City | NEW YORK
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State | NY
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Zip | 10128-1211
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Country | US
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Telephone | 212-423-0730
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 035899
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License Number State | NY
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