Organization
ADVANCED LUNG CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM DAVIDOFF DO (OWNER)
(917) 621-5042
Entity
Organization
Contact information
Practice address
134 GREAT EAST NECK RD, WEST BABYLON, NY 11704-8027
(917) 621-5042
(516) 517-9515
Mailing address
2557 GLENN DR, BELLMORE, NY 11710-5027
(917) 621-5042
(516) 517-9515
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095090
LICENSE
NY
Enumeration date
03/19/2020
Last updated
09/12/2024
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