Provider Demographics
NPI:1013573799
Name:NAVI, MAXINE
Entity Type:Individual
Prefix:DR
First Name:MAXINE
Middle Name:
Last Name:NAVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 KINGS PL
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1646
Mailing Address - Country:US
Mailing Address - Phone:516-849-1649
Mailing Address - Fax:
Practice Address - Street 1:METROPOLITAN HOSPITAL DEPARTMENT OF DENTISTRY
Practice Address - Street 2:1901 1ST AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-6271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0613301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice