Individual
NEDA EGHBALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 W MERRICK RD STE 103, VALLEY STREAM, NY 11580-5252
(516) 599-1701
Mailing address
STONY BROOK SCHOOL OF DENTAL MEDICINE, 151 WESTCHESTER HALL, STONYBROOK, NY 11794-8711
(631) 444-2557
(631) 444-6013
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
060520
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2018
Last updated
11/02/2021
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