| Boro Park Orthodontic Assoc. | |
|
1520 50th St Brooklyn NY 11219-3745 | |
| (718) 871-6663 | |
| (718) 431-2452 |
| Full Name | Boro Park Orthodontic Assoc. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1520 50th St, Brooklyn, New York |
| Authorized Official Name and Position | Phillip Rosenberg (OWNER) |
| Authorized Official Contact | 7188716663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boro Park Orthodontic Assoc. 1520 50th St Brooklyn NY 11219-3745 Ph: (718) 871-6663 | Boro Park Orthodontic Assoc. 1520 50th St Brooklyn NY 11219-3745 Ph: (718) 871-6663 |
| NPI Number | 1568851954 |
|---|---|
| Provider Enumeration Date | 01/22/2015 |
| Last Update Date | 01/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568851954 | NPI | - | NPPES |
| 00301428 | Medicaid | NY | |
| 03534690 | Medicaid | NY | |
| 03448359 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (New York) | Primary |
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