| Kleinrock Nyso Llc | |
|
1705 Broadway Ste 2 Hewlett NY 11557-1600 | |
| (516) 593-0082 | |
| Not Available |
| Full Name | Kleinrock Nyso Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1705 Broadway Ste 2, Hewlett, New York |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kleinrock Nyso Llc 1705 Broadway Ste 2 Hewlett NY 11557-1600 Ph: (516) 593-0082 | Kleinrock Nyso Llc 1705 Broadway Ste 2 Hewlett NY 11557-1600 Ph: (516) 593-0082 |
| NPI Number | 1235709353 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 06/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235709353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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