Individual
MR. MICHAEL LEE DAVIDOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
159 WHITMAN DR, BROOKLYN, NY 11234-6702
(917) 400-0410
Mailing address
159 WHITMAN DR, BROOKLYN, NY 11234-6702
(917) 400-0410
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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