MEDICARE: NTV OFFICE CORP

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	046530	NY

General Provider Information

NPI Number	:	1295907798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NTV OFFICE CORP

Provider Business Mailing Address
First Line	:	8916 ROOSEVELT AVE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7857
Country	:	US
Telephone Number	:	718-446-5895
Fax Number	:	718-446-1828

Provider Business Practice Location Address
First Line	:	8916 ROOSEVELT AVE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7857
Country	:	US
Telephone Number	:	718-446-5895
Fax Number	:	718-446-1828

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NORA E VASQUEZ IX
Credential	:	DDS
Telephone Number	:	718-446-5895

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	03/25/2008

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Directions to “NTV OFFICE CORP ” Practice Location

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