Provider Demographics
NPI:1497101422
Name:DAVYDOV, IRINA (MS ED SPED)
Entity Type:Individual
Prefix:MS
First Name:IRINA
Middle Name:
Last Name:DAVYDOV
Suffix:
Gender:F
Credentials:MS ED SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 OCEANA DR E
Mailing Address - Street 2:APT 4H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6676
Mailing Address - Country:US
Mailing Address - Phone:917-662-3794
Mailing Address - Fax:
Practice Address - Street 1:45 OCEANA DR E
Practice Address - Street 2:APT 4H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6676
Practice Address - Country:US
Practice Address - Phone:917-662-3794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist