Individual
ANI COADERAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-5731
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062723
NY
Other
Enumeration date
04/10/2021
Last updated
12/01/2022
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