EAST 63RD STREET NPI 1811328297

NPI Information

  • NPI: 1811328297
  • Provider Name: EAST 63RD STREET
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Doing Business As: ADVANCED ORAL SURGERY NYC
  • Address: 250 E 63RD ST
    NEW YORK, NY
    ZIP 10065
  • Phone: (212) 644-7009

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NPI Details

EAST 63RD STREET is an oral and maxillofacial surgery dentist in New York, NY. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. EAST 63RD STREET NPI is 1811328297. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Advanced Oral Surgery Nyc.

The provider's business location address is:

250 E 63RD ST
NEW YORK, NY
ZIP 10065-661
Phone: (212) 644-7009

The provider's authorized official is Baruch Tetri .
The authorized official title is Dds and has the following contact phone number (212) 759-5363.

The enumeration date for this NPI number is 12/10/2013 and was last updated on 12/10/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery056681NEW YORKYes

What is NPI?

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This page was last updated on: 11/21/2025

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