Magidenko, Roman
Magidenko, Roman is an individual health care provider with primary practice located at 761 Lydig Ave Ground Floor, Bronx NY 10462. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Magidenko, Roman can be contacted via phone (718) 792-4782.Contact Information
Primary practice address
761 Lydig Ave Ground Floor
Bronx NY 10462
Phone: (718) 792-4782
Fax: (718) 792-4827
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 046633 | New York |
Profile Details
| NPI number | 1619941788 |
|---|---|
| LBN Legal business name | Magidenko, Roman |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 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 | 1619941788 | NPPES |
| New York | MEDICAID | 01751197 |
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