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General NPI Number Information
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NPI Number | 1790949931
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Entity Type | Individual
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Provider Name | LISA UGLIALORO D.D.S., M.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 115 CENTRAL PARK WEST, SUITE 2
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City | NEW YORK
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State | NY
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Zip | 10023-4198
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Country | US
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Telephone | 212-362-3360
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Fax |
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Provider Business Mailing Address
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Address Line | 8911 160TH AVE
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City | HOWARD BEACH
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State | NY
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Zip | 11414-3142
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Country | US
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Telephone | 917-217-3758
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 053897
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 053897
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License Number State | NY
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