Organization
GASTROENTEROLOGY & NUTRITION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL DAVIDOFF MD (OFFICER)
(718) 261-0900
Entity
Organization
Contact information
Practice address
10816 72ND AVE, 2 FLOOR, FOREST HILLS, NY 11375-5653
(718) 261-0900
(718) 261-0944
Mailing address
10816 72ND AVE, 2 FLOOR, FOREST HILLS, NY 11375-5653
(718) 261-0900
(718) 261-0944
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
229243
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922055276
NPI
NY
Enumeration date
08/04/2008
Last updated
10/12/2012
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