MEDICARE: METROPOLITAN DENTAL ASSOCIATES 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
1	1223G0001X	General Practice Dentistry	029752	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1548229958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROPOLITAN DENTAL ASSOCIATES DDS PC

Provider Business Mailing Address
First Line	:	225 BROADWAY
Second Line	:	MEZZANINE LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10007-3001
Country	:	US
Telephone Number	:	212-732-7400
Fax Number	:	212-732-0267

Provider Business Practice Location Address
First Line	:	225 BROADWAY
Second Line	:	MEZZANINE LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10007-3001
Country	:	US
Telephone Number	:	212-732-7400
Fax Number	:	212-732-0267

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL IRVING COHEN
Credential	:	DDS
Telephone Number	:	212-732-7400

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	08/18/2017

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