MEDICARE: DR. RABIEL AMIRIAN 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	052892	NY

General Provider Information

NPI Number	:	1114143963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RABIEL AMIRIAN DDS

Provider Business Mailing Address
First Line	:	142 JORALEMON ST
Second Line	:	6E
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4747
Country	:	US
Telephone Number	:	718-360-1828
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 JORALEMON ST
Second Line	:	6E
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4747
Country	:	US
Telephone Number	:	718-360-1828
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	04/13/2020

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