Provider Demographics
NPI:1053467282
Name:GUROVICH, TANYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:
Last Name:GUROVICH
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 1:345 E 37TH ST
Mailing Address - Street 2:SUITE 319
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3256
Mailing Address - Country:US
Mailing Address - Phone:201-232-6967
Mailing Address - Fax:212-880-2701
Practice Address - Street 1:345 E 37TH ST
Practice Address - Street 2:SUITE 319
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3256
Practice Address - Country:US
Practice Address - Phone:201-232-6967
Practice Address - Fax:212-880-2701
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051810-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist