Provider Demographics
NPI:1801999347
Name:MOSTEL, HAROLD (DDS)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:MOSTEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 CENTRAL AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559
Mailing Address - Country:US
Mailing Address - Phone:516-239-0537
Mailing Address - Fax:516-239-0538
Practice Address - Street 1:290 CENTRAL AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559
Practice Address - Country:US
Practice Address - Phone:516-239-0537
Practice Address - Fax:516-239-0538
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0431271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01370790Medicaid