MEDICARE: VICTORIA CHIARENZA D.M.D

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	1223P0221X	Pediatric Dentistry	059164	NY

General Provider Information

NPI Number	:	1346604360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA CHIARENZA D.M.D

Provider Business Mailing Address
First Line	:	4802 10TH AVENUE
Second Line	:	MAIMONIDES MEDICAL CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 E 106TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-4005
Country	:	US
Telephone Number	:	347-916-8345
Fax Number	:

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

Provider Enumeration Date	:	04/06/2016
Last Update Date	:	04/02/2024

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