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NPI Code Detail

MEDICARE: DR. MARC GOTTLIEB

MEDICARE:  DR. MARC  GOTTLIEB
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 Dentistry036840NY

General Provider Information

NPI Number : 1114931243
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARC GOTTLIEB
Provider Business Mailing Address
First Line : 3601 HEMPSTEAD TPKE
Second Line :
City : LEVITTOWN
State : NY
Zip : 11756-1375
Country : US
Telephone Number : 516-796-6600
Fax Number :
Provider Business Practice Location Address
First Line : 3601 HEMPSTEAD TPKE
Second Line :
City : LEVITTOWN
State : NY
Zip : 11756-1375
Country : US
Telephone Number : 516-796-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARC GOTTLIEB ” Practice Location

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