Provider Demographics
NPI:1326221730
Name:SOYFER, ALEKSANDR (DDS)
Entity Type:Individual
Prefix:
First Name:ALEKSANDR
Middle Name:
Last Name:SOYFER
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 1:60 OCEANA DR W
Mailing Address - Street 2:#5A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6662
Mailing Address - Country:US
Mailing Address - Phone:917-834-3998
Mailing Address - Fax:
Practice Address - Street 1:115 BRIGHTWATER CT
Practice Address - Street 2:1G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7652
Practice Address - Country:US
Practice Address - Phone:917-834-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048907-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02074142Medicaid