Organization
HARLEM 26 DENTAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA A PITKOUVICH (MANAGER)
(917) 391-8000
Entity
Organization
Contact information
Practice address
63 W 125TH ST, SECOND FLOOR, NEW YORK, NY 10027-4590
(212) 348-3600
(212) 348-3900
Mailing address
63 W 125TH ST, SECOND FLOOR, NEW YORK, NY 10027-4590
(212) 348-3600
(212) 348-3900
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NY
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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