Individual
DR. ADI DAVIDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
440 SEAVIEW AVE, STATEN ISLAND, NY 10305-3401
(718) 226-6550
Mailing address
1 EDGEWATER ST, 6TH FL. PAYER RELATIONS, STATEN ISLAND, NY 10305-4900
(718) 226-1008
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
212520
NY
207V00000X
Obstetrics & Gynecology Physician
Primary
212520
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02568707
—
NY
Enumeration date
11/21/2005
Last updated
01/28/2011
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