| Manhattan Oral Facial Surgery Llc | |
|
6118 Riverdale Ave Bronx NY 10471-1009 | |
| (929) 222-3070 | |
| (212) 202-6447 |
| Full Name | Manhattan Oral Facial Surgery Llc |
|---|---|
| Speciality | Dentist |
| Location | 6118 Riverdale Ave, Bronx, New York |
| Authorized Official Name and Position | Janet C Bodey (ORAL AND MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 2125675536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manhattan Oral Facial Surgery Llc 6118 Riverdale Ave Bronx NY 10471-1009 Ph: (929) 222-3070 | Manhattan Oral Facial Surgery Llc 6118 Riverdale Ave Bronx NY 10471-1009 Ph: (929) 222-3070 |
| NPI Number | 1528201613 |
|---|---|
| Provider Enumeration Date | 04/20/2009 |
| Last Update Date | 08/12/2019 |
| Medicare PECOS PAC ID | 6709936891 |
|---|---|
| Medicare Enrollment ID | O20090611000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528201613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 054241 (New York) | Primary |
| Provider Name | Janet C Bodey |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568504538 PECOS PAC ID: 8123119179 Enrollment ID: I20090609000488 |
| Provider Name | Jesal Virendra Shah |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1467604363 PECOS PAC ID: 2860621851 Enrollment ID: I20140218000237 |
| Provider Name | Jennifer Lynn Henkin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1083874333 PECOS PAC ID: 7315176294 Enrollment ID: I20140219000933 |
| Provider Name | Mimi Joonyoung Lee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1366604829 PECOS PAC ID: 6709016413 Enrollment ID: I20140225001365 |
| Provider Name | Bradley Adam Hirsch |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1174573976 PECOS PAC ID: 0547492563 Enrollment ID: I20140407000080 |
| Provider Name | Mckinley Lenard Price |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1164679791 PECOS PAC ID: 9032333059 Enrollment ID: I20140613001145 |
| Provider Name | Christopher J Rochford |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710155668 PECOS PAC ID: 9032365465 Enrollment ID: I20150702001423 |
| Provider Name | Isabelle E. Dematteis |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1881991941 PECOS PAC ID: 5294014445 Enrollment ID: I20161111000577 |
| Provider Name | Mohammad Tofigh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194040782 PECOS PAC ID: 6507145588 Enrollment ID: I20161115001056 |
| Provider Name | Hunter Martin |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1396035507 PECOS PAC ID: 2264702703 Enrollment ID: I20170717002180 |
| Provider Name | Prabhdeep S Grewal |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1497712186 PECOS PAC ID: 2365716263 Enrollment ID: I20170915001060 |
| Provider Name | Llisenia E Rivera |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1386837805 PECOS PAC ID: 7719251503 Enrollment ID: I20170918001222 |
| Provider Name | Kevin D Smith |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1588910657 PECOS PAC ID: 8325308646 Enrollment ID: I20180207000097 |
| Provider Name | Maria A Honrado |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1457648552 PECOS PAC ID: 2466705520 Enrollment ID: I20181019001494 |
| Provider Name | Austin Wilson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1255791935 PECOS PAC ID: 5092068924 Enrollment ID: I20181023002659 |
| Provider Name | Imran Ahson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1124255575 PECOS PAC ID: 0840575569 Enrollment ID: I20181031001607 |
| Provider Name | Jaehyuk Choi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1588166185 PECOS PAC ID: 9931512050 Enrollment ID: I20210111001667 |
| Provider Name | Daniel K Han |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1467707489 PECOS PAC ID: 6406193879 Enrollment ID: I20210129002592 |
| Provider Name | Jared M Rosenstock |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1669889119 PECOS PAC ID: 9537578687 Enrollment ID: I20210503000978 |
| Provider Name | Kathleen Hofmann |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1013410711 PECOS PAC ID: 1456760529 Enrollment ID: I20210503001863 |
| Provider Name | Eliezer Brecher |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1134515786 PECOS PAC ID: 8224302260 Enrollment ID: I20210504000353 |
| Provider Name | Anna N Young |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1194163212 PECOS PAC ID: 4587061262 Enrollment ID: I20211229002346 |
| Provider Name | Mohsin K Wazir |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1528444601 PECOS PAC ID: 3678967700 Enrollment ID: I20220307000115 |
| Provider Name | Brian H Sybo |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1669745899 PECOS PAC ID: 6507298601 Enrollment ID: I20231012001186 |
| Provider Name | Aron Titelman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1801460332 PECOS PAC ID: 3375998248 Enrollment ID: I20231012001256 |
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