MEDICARE: MS. MARIANA SAVELYEV 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	122300000X	Dentist	047729	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	D000802-01	OTHER	NY	AMERICHOICE PROVIDER ID

General Provider Information

NPI Number	:	1851380117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIANA SAVELYEV DDS

Provider Business Mailing Address
First Line	:	900 SOUTH AVE
Second Line	:	SUITE 301
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3418
Country	:	US
Telephone Number	:	718-494-2200
Fax Number	:	718-494-2220

Provider Business Practice Location Address
First Line	:	900 SOUTH AVE
Second Line	:	SUITE 301
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3418
Country	:	US
Telephone Number	:	718-494-2200
Fax Number	:	718-494-2220

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	02/06/2013

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