125TH STREET ORTHODONTICS, PC; NPI #1992127765

Contact Information

125TH STREET ORTHODONTICS, PC

360 W 125TH ST
SUITE 8
NEW YORK, NY 10027-4801

Phone: 646-221-8944
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for 125TH STREET ORTHODONTICS, PC

NPI # 1992127765

LBN Legal business name 125TH STREET ORTHODONTICS, PC

Authorized official KENNETH COOPERMAN - (SECRETARY)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/14/2014

Last updated 01/14/2014 - About 12 years ago

Identifiers

NY	License #	046957
NY	Medicaid	02207707

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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