Provider Demographics
NPI:1275753105
Name:DORON, DAVID I (PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:I
Last Name:DORON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10923 71ST RD
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4849
Mailing Address - Country:US
Mailing Address - Phone:718-544-7903
Mailing Address - Fax:718-544-1980
Practice Address - Street 1:10923 71ST RD
Practice Address - Street 2:SUITE 1-C
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4849
Practice Address - Country:US
Practice Address - Phone:718-544-7903
Practice Address - Fax:718-544-1980
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010672-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical