Provider Demographics
NPI:1285813220
Name:A SEAVIEW DENAL ASSOCIATES PC
Entity type:Organization
Organization Name:A SEAVIEW DENAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:DEKHTYA
Authorized Official - Last Name:DEKHTYAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-937-5400
Mailing Address - Street 1:4528 21ST ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5220
Mailing Address - Country:US
Mailing Address - Phone:718-937-5400
Mailing Address - Fax:718-937-5772
Practice Address - Street 1:4528 21ST ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5220
Practice Address - Country:US
Practice Address - Phone:718-937-5400
Practice Address - Fax:718-937-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049030305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization