Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 052412 | NY |
NPI | 1174754410 |
---|---|
Provider Name | Dr. Dana Marzocco |
First Address | New Hyde Park, NY 11040-2531 |
Second Address | New Hyde Park, NY 11040-2531 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 18/10/2016 |