Provider Demographics
NPI:1265664197
Name:SCHREIBER, ELLIOT SLOMOVITS (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:SLOMOVITS
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 W 95TH ST
Mailing Address - Street 2:APT 3B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6103
Mailing Address - Country:US
Mailing Address - Phone:516-841-6247
Mailing Address - Fax:
Practice Address - Street 1:42 BROADWAY
Practice Address - Street 2:SUITE 1515
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1617
Practice Address - Country:US
Practice Address - Phone:212-269-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist