Individual
ELENI MAVRAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
524 BLUFF RD, FORT LEE, NJ 07024-1543
(201) 886-7162
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02592600
NJ
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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