MEDICARE: AISEL L FELIX D.D.S

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	0476681	NY

General Provider Information

NPI Number	:	1801887146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AISEL L FELIX D.D.S

Provider Business Mailing Address
First Line	:	12 HARTWELL PL
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1222
Country	:	US
Telephone Number	:	917-292-9317
Fax Number	:

Provider Business Practice Location Address
First Line	:	9320A ROOSEVELT AVE
Second Line	:
City	:	JACKSON HTS
State	:	NY
Zip	:	11372-7944
Country	:	US
Telephone Number	:	718-396-6009
Fax Number	:

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

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	07/08/2007

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