Provider Demographics
NPI:1003089673
Name:DAVIDOFF, SAM (DO)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:
Last Name:DAVIDOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:317 BROADWAY STE A
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2709
Mailing Address - Country:US
Mailing Address - Phone:631-598-5864
Mailing Address - Fax:631-598-5866
Practice Address - Street 1:317 BROADWAY STE A
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2709
Practice Address - Country:US
Practice Address - Phone:631-598-5864
Practice Address - Fax:631-598-5866
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY240558207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine