Individual
DR. RONALD JAY DAVIDOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
153 HAZARD AVE, ENFIELD, CT 06082-4592
(860) 253-5020
(860) 253-5030
Mailing address
2 BURNETT ST, GRANBY, MA 01033-3312
(413) 536-3520
(860) 253-5030
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
034586
CT
2084P0800X
Psychiatry Physician
52805
MA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
034586
CT
2084P0804X
Child & Adolescent Psychiatry Physician
52805
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023796
NEIGHBORHOOD HEALTH PLAN#
MA
01
—
6178537
MASS HEALTH NUMBER
MA
Enumeration date
08/22/2006
Last updated
05/03/2012
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