Provider Demographics
NPI:1538998331
Name:FEASTERVILLE-APPALOOSA PLLC
Entity type:Organization
Organization Name:FEASTERVILLE-APPALOOSA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-618-7162
Mailing Address - Street 1:1345 AVENUE OF THE AMERICAS
Mailing Address - Street 2:FLOOR 33 - APPALOOSA DENTAL PARTNERS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10105
Mailing Address - Country:US
Mailing Address - Phone:929-618-7162
Mailing Address - Fax:
Practice Address - Street 1:4 ARBOR LN
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4311
Practice Address - Country:US
Practice Address - Phone:929-618-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental