Individual
ALENA R DAVYDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11945 UNION TPKE, FOREST HILLS, NY 11375-6144
(718) 263-5500
Mailing address
1773 W 12TH ST, BROOKLYN, NY 11223-1145
(718) 372-8669
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VB21170R
—
NY
Enumeration date
09/01/2010
Last updated
09/01/2010
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