Individual
JESSICA N MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 FRANKLIN AVE STE 204, GARDEN CITY, NY 11530-5815
(516) 754-0430
Mailing address
520 FRANKLIN AVE STE 204, GARDEN CITY, NY 11530-5815
(516) 417-8820
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
059483-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
04/14/2016
Last updated
12/26/2024
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