Individual
MRS. RENA DAVYDOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6565 BOOTH ST APT 406, REGO PARK, NY 11374-4139
(718) 312-9216
Mailing address
6565 BOOTH ST APT 406, REGO PARK, NY 11374
(718) 312-9216
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1103514
NY
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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