Provider Demographics
NPI:1902879422
Name:CITRIN, MEL STEVEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEL
Middle Name:STEVEN
Last Name:CITRIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 CHIPPEWA CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4111
Mailing Address - Country:US
Mailing Address - Phone:845-368-4203
Mailing Address - Fax:845-362-9657
Practice Address - Street 1:500 NEW HEMPSTEAD RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-1132
Practice Address - Country:US
Practice Address - Phone:845-362-0083
Practice Address - Fax:845-362-9657
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0282931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics