Individual
DAVID RANDALL DYNOF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 CORACI BLVD, STE 1, SHIRLEY, NY 11967-4833
(212) 682-2750
(212) 682-6588
Mailing address
2341 BELLMORE AVE, BELLMORE, NY 11710-5624
(516) 781-8100
(516) 781-8133
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
225074-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02613927
—
NY
Enumeration date
08/02/2005
Last updated
02/21/2018
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