Individual
MADELINE JUNE PITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8515 4TH AVE, BROOKLYN, NY 11209-4607
(646) 893-0400
Mailing address
8515 4TH AVE, BROOKLYN, NY 11209-4607
(516) 807-1962
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
061503
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/14/2019
Last updated
06/14/2023
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