Individual
KENIA ESMERALDA AMADOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
760 BROADWAY, BROOKLYN, NY 11206-5317
(718) 963-5765
Mailing address
760 BROADWAY, BROOKLYN, NY 11206-5317
(718) 963-5765
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
061757-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/19/2019
Last updated
02/14/2022
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