MEDICARE: HEILBUT, ROSENMAN, RADIN, AND CHO PC

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	1223G0001X	General Practice Dentistry	044918	NY

General Provider Information

NPI Number	:	1154455624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEILBUT, ROSENMAN, RADIN, AND CHO PC

Provider Business Mailing Address
First Line	:	59 E 54TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4211
Country	:	US
Telephone Number	:	212-753-3117
Fax Number	:	212-644-7092

Provider Business Practice Location Address
First Line	:	59 E 54TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4211
Country	:	US
Telephone Number	:	212-753-3117
Fax Number	:	212-644-7092

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. TIMOTHY RADIN
Credential	:	DDS
Telephone Number	:	212-753-3117

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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