Provider Demographics
NPI:1811291222
Name:RIBALT, LENORE (DMD)
Entity type:Individual
Prefix:DR
First Name:LENORE
Middle Name:
Last Name:RIBALT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 MADISON AVE
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1110
Mailing Address - Country:US
Mailing Address - Phone:212-380-1165
Mailing Address - Fax:
Practice Address - Street 1:295 MADISON AVE
Practice Address - Street 2:FLOOR 28
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6304
Practice Address - Country:US
Practice Address - Phone:212-697-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055331122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist