Individual
DR. ADRIANA MEDIAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1405 OLD NORTHERN BLVD, ROSLYN, NY 11576-2252
(516) 801-6777
Mailing address
8900 VAN WYCK EXPY, RICHMOND HILL, NY 11418-2832
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
063481
NY
Other
Enumeration date
05/09/2022
Last updated
01/31/2024
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