MEDICARE: DR. JOSEPH ALAN LICHTER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	047365	NY

General Provider Information

NPI Number	:	1033199302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH ALAN LICHTER DDS

Provider Business Mailing Address
First Line	:	1420 AVENUE P FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1189
Country	:	US
Telephone Number	:	718-339-7878
Fax Number	:	718-339-6611

Provider Business Practice Location Address
First Line	:	1420 AVENUE P FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1189
Country	:	US
Telephone Number	:	718-339-7878
Fax Number	:	718-339-6611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	10/30/2018

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