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NPI Code Detail

MEDICARE: GREGORY J HASKIN DDS PC

MEDICARE: GREGORY J HASKIN DDS 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
1122300000XDentist0399641NY
2261QD0000XDental Clinic/Center0399641NY

General Provider Information

NPI Number : 1275793317
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREGORY J HASKIN DDS PC
Provider Business Mailing Address
First Line : 4571 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-2025
Country : US
Telephone Number : 718-692-4791
Fax Number : 718-692-3362
Provider Business Practice Location Address
First Line : 4571 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-2025
Country : US
Telephone Number : 718-692-4791
Fax Number : 718-692-3362
Authorized Official
Title or Position : PRESIDENT
Name : DR. GREGORY JEROME HASKIN
Credential : DDS
Telephone Number : 718-692-4791
Provider Enumeration Date : 06/12/2008
Last Update Date : 06/12/2008

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