Individual
EDWARD NISSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6 XAVIER DRIVE, SUITE 310, YONKERS, NY 10704
(914) 423-1111
(914) 423-0333
Mailing address
6 XAVIER DRIVE, SUITE 310, YONKERS, NY 10704
(914) 423-1111
(914) 423-0333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
029069
NY
Other
Enumeration date
09/11/2006
Last updated
07/08/2007
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