MEDICARE: DEBRA ORESTE

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	122300000X	Dentist	046643	NY

General Provider Information

NPI Number	:	1497152607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA ORESTE

Provider Business Mailing Address
First Line	:	157 N OCEAN AVE
Second Line	:	SUITE 2
City	:	PATCHOGUE
State	:	NY
Zip	:	11772-2016
Country	:	US
Telephone Number	:	631-475-6444
Fax Number	:	631-475-6941

Provider Business Practice Location Address
First Line	:	157 N OCEAN AVE
Second Line	:	SUITE 2
City	:	PATCHOGUE
State	:	NY
Zip	:	11772-2016
Country	:	US
Telephone Number	:	631-475-6444
Fax Number	:	631-475-6941

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

Provider Enumeration Date	:	12/03/2014
Last Update Date	:	12/03/2014

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Directions to “ DEBRA ORESTE ” Practice Location

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