Individual
ANNA NEKTALOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
506 LENOX AVE, NEW YORK, NY 10037-1802
(212) 939-2876
Mailing address
506 LENOX AVE, NEW YORK, NY 10037-1802
(212) 939-2876
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062827
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2021
Last updated
04/26/2023
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