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Organization

CORONA 26 MEDICAL & DENTAL MANAGEMENT PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALICIA PITKOUVICH (MANAGER)
(917) 391-8000
Entity
Organization

Contact information

Practice address
10308 ROOSEVELT AVE # 2, CORONA, NY 11368-2330
(718) 533-7000
(718) 397-8000
Mailing address
10308 ROOSEVELT AVE # 2, CORONA, NY 11368-2330
(718) 533-7000

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
03/15/2024
Last updated
03/15/2024
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