Individual
DR. INDRAVADAN DAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2090 JERICHO TPKE, NEW HYDE PARK, NY 11040-4719
(513) 352-7828
(516) 352-7827
Mailing address
2090 JERICHO TPKE, NEW HYDE PARK, NY 11040-4719
(513) 352-7828
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C41876
CA
207R00000X
Internal Medicine Physician
C41876
CA
208D00000X
General Practice Physician
Primary
109643
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C418760
—
CA
Enumeration date
06/15/2006
Last updated
02/14/2023
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