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NPI Code Detail

MEDICARE: EXCELDENT OF WESTCHESTER , LLP

MEDICARE: EXCELDENT OF WESTCHESTER , LLP
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 Dentistry049246NY

General Provider Information

NPI Number : 1588763080
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCELDENT OF WESTCHESTER , LLP
Provider Business Mailing Address
First Line : 2176 CENTRAL PARK AVENUE
Second Line :
City : YONKERS
State : NY
Zip : 10710-1826
Country : US
Telephone Number : 914-337-2600
Fax Number : 914-337-2483
Provider Business Practice Location Address
First Line : 2176 CENTRAL PARK AVE
Second Line :
City : YONKERS
State : NY
Zip : 10710-1826
Country : US
Telephone Number : 914-337-2600
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : DR. JEREMY SEAN LUBIN
Credential : D.D.S.
Telephone Number : 914-337-2600
Provider Enumeration Date : 09/21/2006
Last Update Date : 02/25/2009

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Directions to “EXCELDENT OF WESTCHESTER , LLP ” Practice Location

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