Organization
HOLLIS MEDICAL CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMON DAVYDOV (ADMINISTRATOR)
(718) 740-0710
Entity
Organization
Contact information
Practice address
19002 JAMAICA AVE, HOLLIS, NY 11423-2516
(718) 740-0710
(718) 740-0755
Mailing address
19002 JAMAICA AVE, HOLLIS, NY 11423-2516
(718) 740-0710
(718) 740-0755
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00201583
—
NY
05
—
02573462
—
NY
05
—
02724578
—
NY
Enumeration date
06/20/2007
Last updated
09/11/2025
Update your record
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