Provider Demographics
NPI:1609191501
Name:PYRCHLA, ALDONA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALDONA
Middle Name:
Last Name:PYRCHLA
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 1:511 68TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-6005
Mailing Address - Country:US
Mailing Address - Phone:718-238-3025
Mailing Address - Fax:718-238-3026
Practice Address - Street 1:511 68TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-6005
Practice Address - Country:US
Practice Address - Phone:718-238-3025
Practice Address - Fax:718-238-3026
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0514811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02826011Medicaid