=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457562514
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LIMOR OPHIR-TSABARY D.D.S
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12 E 37TH ST 2ND FLOOR
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-2823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-709-9882
-----------------------------------------------------
Fax | 212-889-8891
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1623 3RD AVE #12G
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10128-3638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-297-1838
-----------------------------------------------------
Fax | 212-860-7935
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 049086
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------