Provider Demographics
NPI:1760017842
Name:NEW YORK UNIVERSITY
Entity Type:Organization
Organization Name:NEW YORK UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE DEAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, MPA
Authorized Official - Phone:212-995-4240
Mailing Address - Street 1:345 EAST 24TH STREET
Mailing Address - Street 2:SUITE 10W, NYU DENTISTRY CLINICAL ADMINISTRATION
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010
Mailing Address - Country:US
Mailing Address - Phone:212-992-7089
Mailing Address - Fax:
Practice Address - Street 1:445 ALBEE SQUARE WEST
Practice Address - Street 2:FLOORS 4A/5A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:212-992-7089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty