Individual
DEBORAH ANN HAUERSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 E 68TH ST, SUITE F2132, MAILBOX 275, NEW YORK, NY 10021-4870
(212) 746-5175
(212) 746-8400
Mailing address
525 E 68TH ST, SUITE F2132, MAILBOX 275, NEW YORK, NY 10021-4870
(212) 746-5175
(212) 746-8400
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
047012
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047012
LICENSE
NY
Enumeration date
11/01/2006
Last updated
07/08/2007
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