Individual
TAHELA DAVIDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
27005 76TH AVE # 11040, NEW HYDE PARK, NY 11040-1402
(718) 470-7000
Mailing address
3071 NOSTRAND AVE, BROOKLYN, NY 11229-2643
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
623489-1
NY
367500000X
Certified Registered Nurse Anesthetist
APRN11019642
FL
Other
Enumeration date
09/11/2019
Last updated
07/11/2022
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