Provider Demographics
NPI:1245301993
Name:STANLEY C HEIFETZ
Entity type:Organization
Organization Name:STANLEY C HEIFETZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HEIFETZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-682-3260
Mailing Address - Street 1:275 MADISON AVENUE
Mailing Address - Street 2:SUITE 2210
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-682-3260
Mailing Address - Fax:212-682-2516
Practice Address - Street 1:275 MADISON AVENUE
Practice Address - Street 2:SUITE 2210
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-682-3260
Practice Address - Fax:212-682-2516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty