MEDICARE: DR. ANDREY IVANOV 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
1	1223G0001X	General Practice Dentistry	049734	NY

General Provider Information

NPI Number	:	1578883419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREY IVANOV DDS

Provider Business Mailing Address
First Line	:	803 PLAZA DR
Second Line	:
City	:	WOODBRIDGE
State	:	NJ
Zip	:	07095-1114
Country	:	US
Telephone Number	:	732-636-7624
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 FULTON ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5309
Country	:	US
Telephone Number	:	718-596-5378
Fax Number	:

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

Provider Enumeration Date	:	06/02/2010
Last Update Date	:	06/02/2010

Similar Medicare Providers

1598781627 — WALGREEN CO
Practice Location Address:

559 FULTON ST
BROOKLYN, NY
11201-5309

Practice Phone: 718-643-9505
Practice Fax: 718-643-1383

1770692287 — RITE AID OF NEW YORK INC
Practice Location Address:

559 563 FULTON STREET
BROOKLYN, NY
11201-5309

Practice Phone: 718-643-3570
Practice Fax:

1396807061 — DR. BRUCE FELD D.M.D.
Practice Location Address:

579 FULTON ST
BROOKLYN, NY
11201-5309

Practice Phone: 718-643-0600
Practice Fax:

1205151933 — KHALID BOUZIRI RPH
Practice Location Address:

559 FULTON ST
BROOKLYN, NY
11201-5309

Practice Phone: 718-643-9505
Practice Fax:

1710204169 — DR. YELENA RAFAILOVA PHARMD
Practice Location Address:

559 FULTON ST
BROOKLYN, NY
11201-5309

Practice Phone: 718-643-9505
Practice Fax: 718-643-1383

1063502854 — MRS. ANNA M PITTS-WHITE NP
Practice Location Address:

2094 PITKIN AVE
BROOKLYN, NY
11207-5309

Practice Phone: 718-240-0400
Practice Fax: 718-240-0564

Directions to “ DR. ANDREY IVANOV DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.