Provider Demographics
NPI:1942640826
Name:DAVIDOFF, DORA
Entity Type:Individual
Prefix:
First Name:DORA
Middle Name:
Last Name:DAVIDOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 POST AVE
Mailing Address - Street 2:SUITE 355
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2233
Mailing Address - Country:US
Mailing Address - Phone:718-878-4099
Mailing Address - Fax:516-414-4563
Practice Address - Street 1:265 POST AVE
Practice Address - Street 2:SUITE 355
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2233
Practice Address - Country:US
Practice Address - Phone:718-878-4099
Practice Address - Fax:516-414-4563
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency