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General NPI Number Information
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NPI Number | 1265753768
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Entity Type | Individual
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Provider Name | ROHINI MATHRANI ROHINI MATHRANI
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Gender | Female
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 3745 75TH ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6435
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Country | US
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Telephone | 718-898-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 226 E 85TH ST APT 5D
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City | NEW YORK
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State | NY
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Zip | 10028-3088
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Country | US
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Telephone | 847-975-5168
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 05054883
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License Number State | NY
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