Individual
JEREMY LALAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 STEWART AVE STE 102, WESTBURY, NY 11590-6611
(166) 830-8885
Mailing address
10156 123RD ST, JAMAICA, NY 11419-2124
(347) 891-3622
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
063418
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2022
Last updated
04/11/2025
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