Individual
DR. MICHAEL YEHUDA IVRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
44 S CENTRAL AVE STE 2, VALLEY STREAM, NY 11580
(516) 561-7788
(516) 596-7455
Mailing address
943 HAWKINS AVE, LAKE GROVE, NY 11755-1604
(631) 585-6880
(631) 585-0745
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0479621
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154509503
—
NY
Enumeration date
02/07/2008
Last updated
05/30/2018
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