Individual
DEVANG DAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 PARSONS BLVD, FLUSHING, NY 11355-2205
(718) 670-5486
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7889
(631) 454-4163
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
187890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01454484
—
NY
Enumeration date
11/20/2006
Last updated
08/04/2010
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