Provider Demographics
NPI:1134256688
Name:STEPHEN POSOVSKY, DDS
Entity type:Organization
Organization Name:STEPHEN POSOVSKY, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:POSOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-483-9488
Mailing Address - Street 1:50 CLINTON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4281
Mailing Address - Country:US
Mailing Address - Phone:516-483-9488
Mailing Address - Fax:516-489-4853
Practice Address - Street 1:50 CLINTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4281
Practice Address - Country:US
Practice Address - Phone:516-483-9488
Practice Address - Fax:516-489-4853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0304851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02519762Medicaid