NPI 1063802627

Oral and Implant Surgery of Manhattan, PLLC

Organisation Oral & Maxillofacial Surgery (D.M.D.) New York, NY

Practice location

Address: 18 E 48th St Suite 1502, New York, NY 10017-1014
Phone: (212) 752-8600
Fax: (203) 661-0155
Mailing address: 455 W 23rd St APT. 17ab, New York, NY 10011-2148

Authorised official

Name: Michele Shoshana Bergen
Title: Sole Member
Phone: (212) 752-8600

Registered specialties

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 231685 (NY)

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Registry record

NPI: 1063802627
Entity type: Organization
NPI issued: 3 Feb 2015
Record last updated: 3 Feb 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.