Individual
DR. JONATHAN STEPHEN AIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
356 BROADWAY, NEW YORK, NY 10013
(718) 843-0572
(718) 843-0572
Mailing address
2 1/2 LAKE STREET, STAMFORD, NY 12167
(607) 652-4333
(607) 652-4333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
035738
NY
1223G0001X
General Practice Dentistry
Primary
035738
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00854311
—
NY
Enumeration date
06/07/2007
Last updated
05/19/2016
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