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NPI Code Detail

MEDICARE: ALAN ELLMAN - HARVEY LINDENBAUM DDS

MEDICARE: ALAN ELLMAN - HARVEY LINDENBAUM DDS
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
1122300000XDentist29544NY
2122300000XDentist29649NY

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 : 1558365585
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALAN ELLMAN - HARVEY LINDENBAUM DDS
Provider Business Mailing Address
First Line : 770 MIDDLE COUNTRY RD
Second Line :
City : MIDDLE ISLAND
State : NY
Zip : 11953-2542
Country : US
Telephone Number : 631-924-7997
Fax Number : 631-924-7953
Provider Business Practice Location Address
First Line : 770 MIDDLE COUNTRY RD
Second Line :
City : MIDDLE ISLAND
State : NY
Zip : 11953-2542
Country : US
Telephone Number : 631-924-7997
Fax Number : 631-924-7953
Authorized Official
Title or Position : OWNER
Name : DR. HARVEY LINDENBAUM
Credential : DDS
Telephone Number : 631-924-7997
Provider Enumeration Date : 06/08/2005
Last Update Date : 08/22/2020

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