Individual
GEORGE DAVYDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14130 70TH RD, FLUSHING, NY 11367-1937
(171) 826-3789
Mailing address
170 WILLIAM ST, NEW YORK, NY 10038-2612
(646) 812-4614
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
018986
NY
363AS0400X
Surgical Physician Assistant
25MP00542200
NJ
Other
Enumeration date
09/16/2015
Last updated
01/02/2024
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