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NPI Code Detail

MEDICARE: MANAL GERGES D.D.S.

MEDICARE:   MANAL  GERGES  D.D.S.
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
11223G0001XGeneral Practice Dentistry041974NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073657730
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANAL GERGES D.D.S.
Provider Business Mailing Address
First Line : 23520 147TH AVE STE 3
Second Line :
City : ROSEDALE
State : NY
Zip : 11422-3293
Country : US
Telephone Number : 718-723-4878
Fax Number :
Provider Business Practice Location Address
First Line : 23520 147TH AVE STE 3
Second Line :
City : ROSEDALE
State : NY
Zip : 11422-3293
Country : US
Telephone Number : 718-723-4878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 07/08/2007

Similar Medicare Providers

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Practice Location Address:
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1275625378 — DR. MANOJ SADHNANI INC.
Practice Location Address:
235-20 147TH AVE , SUITE 7
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Directions to “ MANAL GERGES D.D.S.” Practice Location

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