Fridman, Tatyana

Fridman, Tatyana is an individual health care provider with primary practice located at 5412 Kings Plaza Mall , Brooklyn NY 11234. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Fridman, Tatyana can be contacted via phone (718) 258-0011.

Contact Information

Primary practice address
5412 Kings Plaza Mall Brooklyn NY 11234
Phone: (718) 258-0011
Fax: (718) 258-1405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 050703-1 New York

Profile Details

NPI number 1689685620
LBN Legal business name Fridman, Tatyana
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1689685620 NPPES
New York MEDICAID 02530023

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