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General NPI Number Information
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NPI Number | 1518257419
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Entity Type | Individual
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Provider Name | ALISA NEYMARK D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 127 W 79TH ST
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City | NEW YORK
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State | NY
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Zip | 10024-6598
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Country | US
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Telephone | 212-580-4790
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Fax |
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Provider Business Mailing Address
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Address Line | 8 OLD POST RD
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City | MOUNT SINAI
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State | NY
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Zip | 11766-1100
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Country | US
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Telephone | 718-753-9088
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 056516
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License Number State | NY
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