Provider Demographics
NPI:1740402718
Name:CIAVARELLA, MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:CIAVARELLA
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 1:160-10 27TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1012
Mailing Address - Country:US
Mailing Address - Phone:718-767-0606
Mailing Address - Fax:718-767-1786
Practice Address - Street 1:160-10 27TH AVENUE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1012
Practice Address - Country:US
Practice Address - Phone:718-767-0606
Practice Address - Fax:718-767-1786
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0371191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice