Organization
ONE ENDO SUPPORT SERVICES
Active
Other names
One Endo
Organization subpart
No
Provider details
NPI number
Authorized official
LORI MICELI (INSURANCE COORDINATOR)
(914) 777-9465
Entity
Organization
Contact information
Practice address
515 HALSTEAD AVE, MAMARONECK, NY 10543-2715
(914) 777-9465
(914) 777-9467
Mailing address
515 HALSTEAD AVE, MAMARONECK, NY 10543-2715
(914) 777-9465
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049672
ENDODONTICS
NY
01
—
059156
ENDODONTICS
NY
01
—
059403
ENDODONTICS
NY
01
—
060253
ENDODONTICS
NY
01
—
1023471372
ENDODONTICS
—
01
—
1114459328
ENDODONTICS
—
01
—
12538
ENDODONTICS
CT
01
—
12542
ENDODONTICS
CT
01
—
1326131236
ENDODONTICS
—
Enumeration date
03/16/2022
Last updated
03/16/2022
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