| Prestige Fifth Avenue Dental P C | |
|
110 E 40th St Rm 406 New York NY 10016-1801 | |
| (212) 682-5060 | |
| (212) 683-4330 |
| Full Name | Prestige Fifth Avenue Dental P C |
|---|---|
| Speciality | Dentist |
| Location | 110 E 40th St Rm 406, New York, New York |
| Authorized Official Name and Position | Yelena Simkha (DDS) |
| Authorized Official Contact | 2126825060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Fifth Avenue Dental P C 110 E 40th St Rm 406 New York NY 10016-1801 Ph: (212) 682-5060 | Prestige Fifth Avenue Dental P C 110 E 40th St Rm 406 New York NY 10016-1801 Ph: (212) 682-5060 |
| NPI Number | 1417317124 |
|---|---|
| Provider Enumeration Date | 02/24/2016 |
| Last Update Date | 02/24/2016 |
| Medicare PECOS PAC ID | 7719286475 |
|---|---|
| Medicare Enrollment ID | O20160502000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417317124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| Provider Name | Yelena Simkha |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043471840 PECOS PAC ID: 4981903648 Enrollment ID: I20160502000277 |
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