Organization
DR AARON DAVID AND DR LARISSA FOMITCHEVA OB/GYN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SETH MALAMUT (MANAGER)
(516) 336-4030
Entity
Organization
Contact information
Practice address
980 N BROADWAY, MASSAPEQUA, NY 11758-2355
(516) 795-2890
(516) 795-7450
Mailing address
980 N BROADWAY, MASSAPEQUA, NY 11758-2355
(516) 795-2890
(516) 795-7450
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00904178
—
NY
Enumeration date
03/19/2014
Last updated
03/19/2014
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