Matthew A Nissenbaum in Lindenhurst - Orthodontics And Dentofacial Orthopedics
Matthew A Nissenbaum - NPI 1528192713
Matthew A Nissenbaum is a Orthodontics And Dentofacial Orthopedics in Lindenhurst, New York. Matthew A Nissenbaum practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for Matthew A Nissenbaum is 1528192713. The last update date is 2007-07-08.
Matthew A Nissenbaum's current location address is 221 N Wellwood Ave, Lindenhurst, New York. You can contact this provider via phone number 6312258000 and fax number 6312257077. The mailing address for Matthew A Nissenbaum is 221 N Wellwood Ave, Lindenhurst, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Matthew A Nissenbaum |
|---|---|
| Address | 221 N Wellwood Ave, Lindenhurst, New York |
| Phone Number | 6312258000 |
| Fax Number | 6312257077 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1528192713 |
|---|---|
| Provider Enumeration Date | 2007-03-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 221 N Wellwood Ave |
|---|---|
| City | Lindenhurst |
| State | New York (NY) |
| Post Code | 117573706 |
| Phone Number | 6312258000 |
| Fax Number | 6312257077 |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | 048062-1 |
|
Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2771180 | NY | -- |
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What is the Matthew A Nissenbaum's unique identification number?
The Matthew A Nissenbaum has been assigned the NPI (National Provider Identifier) Number 1528192713 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Matthew A Nissenbaum?
The Matthew A Nissenbaum is situated at 221 N Wellwood Ave, in the city of Lindenhurst, state of NY, with the zip code 117573706.
What is the Matthew A Nissenbaum's specialty and taxonomy code?
The Matthew A Nissenbaum's specialty is Orthodontics And Dentofacial Orthopedics, and the corresponding taxonomy code is 1223X0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1528192713 to Matthew A Nissenbaum?
The Centers for Medicare & Medicaid Services assigned the 1528192713 to Matthew A Nissenbaum on 2007-03-16.
As of what date were the Matthew A Nissenbaum's details last updated?
The information pertaining to the Matthew A Nissenbaum, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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