Provider Demographics
NPI:1750641502
Name:FDC ASOCIATES, CORP
Entity Type:Organization
Organization Name:FDC ASOCIATES, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-624-5456
Mailing Address - Street 1:175 HEWES ST
Mailing Address - Street 2:175 HEWES STREET
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-8057
Mailing Address - Country:US
Mailing Address - Phone:718-624-5456
Mailing Address - Fax:
Practice Address - Street 1:175 HEWES STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-8057
Practice Address - Country:US
Practice Address - Phone:718-624-5456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0363151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty