Provider Demographics
NPI:1184020117
Name:NESTOROVSKI, RAQUEL LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAQUEL
Middle Name:LEE
Last Name:NESTOROVSKI
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 1:139 ESSEX ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-2324
Mailing Address - Country:US
Mailing Address - Phone:248-943-2268
Mailing Address - Fax:
Practice Address - Street 1:18 E 50TH ST FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-9110
Practice Address - Country:US
Practice Address - Phone:248-943-2268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-19
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0581461122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist