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NPI Code Detail

MEDICARE: DR. CAMILO DARIO ACHURY DDS

MEDICARE: DR. CAMILO DARIO ACHURY 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
11223G0001XGeneral Practice Dentistry041859NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1041859OTHERNYLICENSE

General Provider Information

NPI Number : 1114096252
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAMILO DARIO ACHURY DDS
Provider Business Mailing Address
First Line : 3545 79TH ST
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-4818
Country : US
Telephone Number : 718-335-1331
Fax Number : 718-396-2593
Provider Business Practice Location Address
First Line : 3545 79TH ST
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-4818
Country : US
Telephone Number : 718-335-1331
Fax Number : 718-396-2593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 07/08/2007

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