MEDICARE: MRS. ANNA ALEKSEYEVA 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
1	1223G0001X	General Practice Dentistry	047231	NY

General Provider Information

NPI Number	:	1255427357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA ALEKSEYEVA D.D.S

Provider Business Mailing Address
First Line	:	145 LIPSETT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-4824
Country	:	US
Telephone Number	:	718-667-4744
Fax Number	:

Provider Business Practice Location Address
First Line	:	2748 OCEAN AVE APT 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4735
Country	:	US
Telephone Number	:	718-376-1666
Fax Number	:	718-376-9180

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	02/02/2021

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