Provider Demographics
NPI:1982166187
Name:ROY I DAVIDOVITCH MD PLLC
Entity Type:Organization
Organization Name:ROY I DAVIDOVITCH MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-708-4401
Mailing Address - Street 1:PO BOX 3109
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10163-3109
Mailing Address - Country:US
Mailing Address - Phone:917-594-4447
Mailing Address - Fax:646-974-6989
Practice Address - Street 1:485 MADISON AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5803
Practice Address - Country:US
Practice Address - Phone:917-594-4447
Practice Address - Fax:646-974-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty