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General NPI Number Information
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NPI Number | 1710668843
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Entity Type | Organization
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Legal Business Name | FORT GREENE ORTHODONTICS PC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 55 GREENE AVE STE LLC
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City | BROOKLYN
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State | NY
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Zip | 11238-6432
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Country | US
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Telephone | 718-576-6166
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Fax |
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Provider Business Mailing Address
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Address Line | 55 GREENE AVE STE LLC
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City | BROOKLYN
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State | NY
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Zip | 11238-6432
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELLIOT ZHARNITSKY
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Credential |
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Telephone | 516-659-9238
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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 |
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License Number State |
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