Provider Demographics
NPI:1760944714
Name:BILLING, DAVID LEE JR
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:BILLING
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 W 104TH ST APT 4R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4111
Mailing Address - Country:US
Mailing Address - Phone:860-912-5518
Mailing Address - Fax:
Practice Address - Street 1:322 W 104TH ST APT 4R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4111
Practice Address - Country:US
Practice Address - Phone:860-912-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program