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General NPI Number Information
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NPI Number | 1487672416
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Entity Type | Individual
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Provider Name | HENRY STANLEY BYLICKY JR. D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24 WASHINGTON AVENUE
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City | SOUTH NYACK
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State | NY
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Zip | 10960
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Country | US
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Telephone | 845-727-4122
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Fax | 845-358-2465
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Provider Business Mailing Address
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Address Line | 260 NORTH REGENT STREET
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City | PORT CHESTER
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State | NY
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Zip | 10573
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Country | US
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Telephone | 914-934-5984
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Fax | 914-934-1616
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 031408
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License Number State | NY
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