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General NPI Number Information
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NPI Number | 1922451418
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Entity Type | Organization
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Legal Business Name | BRACETOWN II, LLP
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 519 BELLMORE AVE
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City | EAST MEADOW
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State | NY
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Zip | 11554-4707
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Country | US
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Telephone | 516-505-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 519 BELLMORE AVE
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City | EAST MEADOW
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State | NY
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Zip | 11554-4707
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Country | US
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Telephone | 516-505-8800
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. SCOTT FRIEDMAN
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Credential | DDS
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Telephone | 515-505-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 34366
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License Number State | NY
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