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General NPI Number Information
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NPI Number | 1609051606
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Entity Type | Individual
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Provider Name | EVAN BARBAKOFF DMD
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Gender | Male
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 34 BARNSLEY CRES
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City | MOUNT SINAI
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State | NY
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Zip | 11766-2802
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Country | US
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Telephone | 631-331-8898
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Fax |
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Provider Business Mailing Address
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Address Line | 1644 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-5211
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Country | US
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Telephone | 631-586-7100
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Fax | 631-586-5476
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 043888
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License Number State | NY
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