Individual
DR. DATEV PIDEDJIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 572-6131
Mailing address
259 1ST ST, MINEOLA, NY 11501-3957
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
194567
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02061076
—
NY
Enumeration date
04/17/2006
Last updated
03/17/2021
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