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NPI Code Detail

MEDICARE: MARIA THERESA AMAGO BENEDICTO YU DDS

MEDICARE: MARIA THERESA AMAGO BENEDICTO YU 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 Dentistry041916NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11223G0001XOTHERNYDENTIST

General Provider Information

NPI Number : 1972509206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA THERESA AMAGO BENEDICTO YU DDS
Provider Business Mailing Address
First Line : 6200 BEACH CHANNEL DR
Second Line :
City : ARVERNE
State : NY
Zip : 11692-1409
Country : US
Telephone Number : 718-945-7150
Fax Number : 718-945-2595
Provider Business Practice Location Address
First Line : 6200 BEACH CHANNEL DR
Second Line :
City : ARVERNE
State : NY
Zip : 11692-1409
Country : US
Telephone Number : 718-945-7150
Fax Number : 718-663-6135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 02/18/2014

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