Provider Demographics
NPI:1144232877
Name:CELLERI-PINCUS, OLGA Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:Y
Last Name:CELLERI-PINCUS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 LAWRENCE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1014
Mailing Address - Country:US
Mailing Address - Phone:516-539-0466
Mailing Address - Fax:516-539-0466
Practice Address - Street 1:101 S BERGEN PL
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3528
Practice Address - Country:US
Practice Address - Phone:516-623-3600
Practice Address - Fax:516-623-9191
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0461781223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02213812Medicaid