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General NPI Number Information
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NPI Number | 1962414466
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Entity Type | Individual
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Provider Name | ELIOT M. HEISLER D.D.S., P.C.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 45 N STATION PLZ SUITE 216
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City | GREAT NECK
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State | NY
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Zip | 11021-5011
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Country | US
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Telephone | 516-829-2001
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Fax | 516-466-4585
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Provider Business Mailing Address
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Address Line | 45 N STATION PLZ SUITE 216
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City | GREAT NECK
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State | NY
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Zip | 11021-5011
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Country | US
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Telephone | 516-829-2001
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Fax | 516-466-4585
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 044354
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License Number State | NY
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