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NPI Code Detail

MEDICARE: DR. STELLA AMINOV DDS

MEDICARE: DR. STELLA AMINOV 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
11223G0001XGeneral Practice Dentistry054029NY

General Provider Information

NPI Number : 1811153372
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STELLA AMINOV DDS
Provider Business Mailing Address
First Line : 9424 63RD DR
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2028
Country : US
Telephone Number : 718-997-7762
Fax Number :
Provider Business Practice Location Address
First Line : 9424 63RD DR
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2028
Country : US
Telephone Number : 718-997-7762
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2008
Last Update Date : 08/04/2008

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