Brocavich, Kristen
Brocavich, Kristen is an individual health care provider with primary practice located at 150 Islip Ave Ste 11 , Islip NY 11751-3222. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Brocavich, Kristen can be contacted via phone (631) 581-3100.Contact Information
Primary practice address
150 Islip Ave Ste 11
Islip NY 11751-3222
Phone: (631) 581-3100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 061138 | New York |
Profile Details
| NPI number | 1851901896 |
|---|---|
| LBN Legal business name | Brocavich, Kristen |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 4th, 2020 |
| Last updated | Aug 4th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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