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NPI Code Detail

MEDICARE: LYUBOV LITVIN D.D.S.

MEDICARE: LYUBOV LITVIN 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
11223G0001XGeneral Practice Dentistry047149NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538158373
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYUBOV LITVIN D.D.S.
Provider Business Mailing Address
First Line : 3091 BRIGHTON 5TH STREET
Second Line : APT 3C
City : BROOKLYN
State : NY
Zip : 11235
Country : US
Telephone Number : 917-704-5138
Fax Number :
Provider Business Practice Location Address
First Line : 1220 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1009
Country : US
Telephone Number : 718-376-1004
Fax Number : 718-376-1150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 07/08/2007

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