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167 Froehlich Farm Blvd Woodbury NY 11797-2906 | |
| (516) 677-9777 | |
| (516) 677-9778 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 167 Froehlich Farm Blvd, Woodbury, New York |
| Authorized Official Name and Position | Slava Shapiro (OWNER) |
| Authorized Official Contact | 5166779777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
118 Greenway Dr S Syosset NY 11791-3854 Ph: (516) 677-9777 | 167 Froehlich Farm Blvd Woodbury NY 11797-2906 Ph: (516) 677-9777 |
| NPI Number | 1891007670 |
|---|---|
| Provider Enumeration Date | 07/08/2010 |
| Last Update Date | 07/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891007670 | NPI | - | NPPES |
| 1003015926 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 049812 (New York) | Primary |
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