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Organization
UNITED MEDICAL DIAGNOSTIC SERVICES P.C.
Active
Organization
UNITED MEDICAL DIAGNOSTIC SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEYMURAZ DATIKASHVILI (MD)
(516) 791-5750
Entity
Organization
Contact information
Practice address
1021 FORDHAM LN, WOODMERE, NY 11598-1013
(516) 791-5750
Mailing address
1021 FORDHAM LN, WOODMERE, NY 11598-1013
(516) 791-5750
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
211676
NY
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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