Provider Demographics
NPI:1922175272
Name:FLEMMING, AMELIA P (RDH)
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:P
Last Name:FLEMMING
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:AMELIA
Other - Middle Name:P
Other - Last Name:HAZEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1321 UNIVERSITY AVE BRONX N.Y. 10452
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10452
Mailing Address - Country:US
Mailing Address - Phone:718-960-2932
Mailing Address - Fax:718-960-2609
Practice Address - Street 1:1225 GERARD AVE BRONX N Y 10452
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10452
Practice Address - Country:US
Practice Address - Phone:718-960-2932
Practice Address - Fax:718-960-2609
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018202-1124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist