Provider Demographics
NPI:1316000763
Name:PILTSER, YAKOV (DDS)
Entity Type:Individual
Prefix:DR
First Name:YAKOV
Middle Name:
Last Name:PILTSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 BARNES AVE 2 FL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1902
Mailing Address - Country:US
Mailing Address - Phone:718-863-4777
Mailing Address - Fax:718-892-8884
Practice Address - Street 1:2134 BARNES AVE 2 FL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1902
Practice Address - Country:US
Practice Address - Phone:718-863-4777
Practice Address - Fax:718-892-8884
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0406471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00836571Medicaid
NY01006211Medicaid