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Individual

DAVID CHAMPLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7301 GRAND AVE, MASPETH, NY 11378-1523
(718) 457-5900
Mailing address
5902 60TH ST, MASPETH, NY 11378-3234

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022770
NY

Other

Enumeration date
10/15/2018
Last updated
10/15/2018
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