Organization
90TH STREET SURGICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DAVYDOV OPA-C (DIRECTOR)
(315) 302-9073
Entity
Organization
Contact information
Practice address
435 E 90TH ST STE 201, NEW YORK, NY 10128-5103
(315) 302-9073
Mailing address
435 E 90TH ST STE 201, NEW YORK, NY 10128-5103
(315) 302-9073
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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