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General NPI Number Information
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NPI Number | 1386811933
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Entity Type | Organization
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Legal Business Name | MICHAEL K EMANUEL DDS SHIRLEY LEW DMD PC
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 2053 EAST 16 STREET
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 718-336-5005
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Fax | 718-336-8679
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Provider Business Mailing Address
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Address Line | 2053 EAST 16 STREET
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 718-336-5005
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Fax | 718-336-8679
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Authorized Official
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Title or Position | ORTHODONTIST PRESIDENT OF PROFESSIO
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Name | DR. MICHAEL K EMANUEL
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Credential | DDS
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Telephone | 718-336-5005
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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 | 30399
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License Number State | NY
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