Provider Demographics
NPI:1154692655
Name:LAYLIEV, EMANUEL (DDS)
Entity type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:
Last Name:LAYLIEV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5014
Mailing Address - Country:US
Mailing Address - Phone:212-288-4455
Mailing Address - Fax:212-288-5260
Practice Address - Street 1:128 E 71ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5014
Practice Address - Country:US
Practice Address - Phone:212-288-4455
Practice Address - Fax:212-288-5260
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049730122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice