Fantasia, John Edward
Fantasia, John Edward is an individual health care provider with primary practice located at 27005 76Th Ave Lijmc, New Hyde Park NY 11040-1433. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Fantasia, John Edward can be contacted via phone (718) 470-7116.Contact Information
Primary practice address
27005 76Th Ave Lijmc
New Hyde Park NY 11040-1433
Phone: (718) 470-7116
Fax: (718) 347-3483
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | 041799-1 | New York |
Profile Details
| NPI number | 1730258286 |
|---|---|
| LBN Legal business name | Fantasia, John Edward |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730258286 | NPPES |
| New York | MEDICAID | 01098053 |
Popular Providers
-
Wu, Josephine
27005 76Th Ave Lijmc, New Hyde Park NY 11040-1433 -
Philipone, Elizabeth
630 W 168Th St Ph 1562 W, New York NY 10032-3725 -
Super, Stuart
800A 5Th Ave Suite 101, New York NY 10021-7215 -
Ruggiero, Salvatore Louis
2001 Marcus Ave Suite N-10, New Hyde Park NY 11042-1011 -
Chandra, Dave
27005 76Th Ave , New Hyde Park NY 11040-1402 -
Tuchman, Mario
353 Lexington Ave Suite #700, New York NY 10016-0941 -
Kramer, Jill M
270-05 76Th Ave , New Hyde Park NY 11040-1402 -
Malpeso, Pasquale J
563 Park Ave , New York NY 10021-7314