| Fordham Road Dental Pc | |
|
327 E Fordham Rd 2nd Floor Bronx NY 10458-5002 | |
| (718) 933-8400 | |
| (718) 933-3731 |
| Full Name | Fordham Road Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 327 E Fordham Rd, Bronx, New York |
| Authorized Official Name and Position | Diane Bertuzzi (PRACTICE MANAGER) |
| Authorized Official Contact | 8453046110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fordham Road Dental Pc 327 E Fordham Rd 2nd Floor Bronx NY 10458-5002 Ph: (718) 933-8400 | Fordham Road Dental Pc 327 E Fordham Rd 2nd Floor Bronx NY 10458-5002 Ph: (718) 933-8400 |
| NPI Number | 1306050869 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 05/26/2016 |
| Medicare PECOS PAC ID | 7416268388 |
|---|---|
| Medicare Enrollment ID | O20150618001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306050869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Goldstein |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1417938655 PECOS PAC ID: 8325359292 Enrollment ID: I20150622002167 |
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