MEDICARE: DR. CLARIBEL UY 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	048407	NY

General Provider Information

NPI Number	:	1811035363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLARIBEL UY DDS

Provider Business Mailing Address
First Line	:	456 N WOODLAND ST
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-2028
Country	:	US
Telephone Number	:	201-988-4591
Fax Number	:

Provider Business Practice Location Address
First Line	:	4011 WARREN ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1734
Country	:	US
Telephone Number	:	718-426-2105
Fax Number	:

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

Provider Enumeration Date	:	02/04/2007
Last Update Date	:	07/08/2007

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