Provider Demographics
NPI:1902923626
Name:SUSAN KARABIN DDS AND EDWARD GOTTESMAN DDS PC
Entity Type:Organization
Organization Name:SUSAN KARABIN DDS AND EDWARD GOTTESMAN DDS PC
Other - Org Name:ROBERT GOTTSEGEN DDS PAUL TANNENBAUM DDS & SUSAN KARABIN DDS PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARABIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-756-8890
Mailing Address - Street 1:218 EAST 61ST STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-756-8890
Mailing Address - Fax:212-756-8899
Practice Address - Street 1:218 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8506
Practice Address - Country:US
Practice Address - Phone:212-756-8890
Practice Address - Fax:212-756-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0233881223P0300X
NY0361401223P0300X
NY0491861223P0300X
NY0464691223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherGROUP TAX ID NUMBER