Provider Demographics
NPI:1902048531
Name:LEIBOWITZ AND CINQUEMANI DDS
Entity Type:Organization
Organization Name:LEIBOWITZ AND CINQUEMANI DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEIBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-275-2929
Mailing Address - Street 1:6051 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5529
Mailing Address - Country:US
Mailing Address - Phone:718-275-2929
Mailing Address - Fax:718-896-4104
Practice Address - Street 1:6051 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5529
Practice Address - Country:US
Practice Address - Phone:718-275-2929
Practice Address - Fax:718-896-4104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEIBOWITZ AND CINQUEMANI DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4033611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty