Individual
DONOVAN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8900 VAN WYCK EXPY, EMERGENCY DEPARTMENT, JAMAICA, NY 11418-2897
(718) 206-6058
(718) 206-6085
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT DEPARTMENT, MELVILLE, NY 11747-4230
(631) 391-7889
(631) 454-4163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011682
NY
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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