Provider Demographics
NPI:1508402819
Name:CINTULA, ANASTASIA MAE (DDS)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:MAE
Last Name:CINTULA
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 1:57 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3003
Mailing Address - Country:US
Mailing Address - Phone:718-801-0545
Mailing Address - Fax:
Practice Address - Street 1:119 W 57TH ST STE 815
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2401
Practice Address - Country:US
Practice Address - Phone:212-974-8737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0617311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice