# UNITED MEDICAL DIAGNOSTIC SERVICES P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457461865
- **Authorized official:** TEYMURAZ DATIKASHVILI (MD)
- **Authorized official phone:** (516) 791-5750

## Contact information

- **Practice address:** 1021 FORDHAM LN, WOODMERE, NY 11598-1013
- **Practice address phone:** (516) 791-5750
- **Mailing address:** 1021 FORDHAM LN, WOODMERE, NY 11598-1013
- **Mailing address phone:** (516) 791-5750

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 211676 | NY | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020