Individual
DR. NEAL B NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2005 AVENUE L, APT. 1F, BROOKLYN, NY 11210-4550
(718) 338-0015
Mailing address
2005 AVENUE L, APT. 1F, BROOKLYN, NY 11210-4550
(718) 338-0015
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
033959-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00412579
—
NY
Enumeration date
12/25/2006
Last updated
07/08/2007
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