Individual
MARY AYOUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 PARK AVE S STE 1414, NEW YORK, NY 10003-1523
(617) 276-4710
Mailing address
150 E 44TH ST APT 26H, NEW YORK, NY 10017-4075
(617) 276-4710
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
064824
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
05/20/2024
Last updated
08/07/2025
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