Organization
PUTNAM PHYSICAL MEDICINE & REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORELEI DAVIDSON M.D. (PRESIDENT)
(845) 628-2004
Entity
Organization
Contact information
Practice address
880 S LAKE BLVD STE 201, MAHOPAC, NY 10541-4771
(845) 628-4400
Mailing address
880 S LAKE BLVD STE 201, MAHOPAC, NY 10541-4771
(845) 628-4400
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
206144
NY
Other
Enumeration date
12/19/2006
Last updated
08/30/2016
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