Provider Demographics
NPI:1336256122
Name:TRICORACHE, IOANA (DDS)
Entity Type:Individual
Prefix:
First Name:IOANA
Middle Name:
Last Name:TRICORACHE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 WASHINGTON SQ W
Mailing Address - Street 2:SUITE 1R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-9126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31 WASHINGTON SQ W
Practice Address - Street 2:SUITE 1R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9126
Practice Address - Country:US
Practice Address - Phone:212-539-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0483211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice