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General NPI Number Information
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NPI Number | 1346430170
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Entity Type | Organization
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Legal Business Name | PRACTICE VALUATION ASSOCIATES,LLC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 237 E 17TH ST
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City | NEW YORK
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State | NY
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Zip | 10003-3664
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Country | US
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Telephone | 212-353-1870
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Fax | 803-803-4516
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Provider Business Mailing Address
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Address Line | 237 E 17TH ST
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City | NEW YORK
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State | NY
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Zip | 10003-3664
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Country | US
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Telephone | 212-353-1870
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Fax | 803-803-4516
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. MITCHELL FROED
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Credential | DDS
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Telephone | 212-353-1870
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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 | DN13882
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License Number State | FL
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