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NPI Code Detail

MEDICARE: DR. VYACHESLAV RIPA D.D.S., PH.D.

MEDICARE: DR. VYACHESLAV RIPA D.D.S., PH.D.
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
1122300000XDentist049788-1NY

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 : 1679606594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VYACHESLAV RIPA D.D.S., PH.D.
Provider Business Mailing Address
First Line : 2833 CONEY ISLAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-5015
Country : US
Telephone Number : 718-946-8585
Fax Number : 347-254-6525
Provider Business Practice Location Address
First Line : 2833 CONEY ISLAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-5015
Country : US
Telephone Number : 718-946-8585
Fax Number : 347-254-6525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 07/21/2022

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