Provider Demographics
NPI:1588815369
Name:DAVIDOV PSYCHIATRIC CARE,P.C.
Entity Type:Organization
Organization Name:DAVIDOV PSYCHIATRIC CARE,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-459-1225
Mailing Address - Street 1:9850 63RD DR
Mailing Address - Street 2:APT. 5G
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2337
Mailing Address - Country:US
Mailing Address - Phone:347-840-0409
Mailing Address - Fax:718-459-5805
Practice Address - Street 1:9520 63RD RD
Practice Address - Street 2:SUITE J
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1145
Practice Address - Country:US
Practice Address - Phone:718-459-1225
Practice Address - Fax:718-459-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health