Provider Demographics
NPI:1316321102
Name:BIRKENFELD, LUCIA (DMD)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:BIRKENFELD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 56TH ST
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3607
Mailing Address - Country:US
Mailing Address - Phone:212-973-9425
Mailing Address - Fax:
Practice Address - Street 1:21 LAWRENCE CT
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-2911
Practice Address - Country:US
Practice Address - Phone:201-569-1795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-12
Last Update Date:2015-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist