Organization
EUGENE DYAKOVETSKY MD. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE DYAKOVETSKY MD (PRESIDENT)
(267) 471-0089
Entity
Organization
Contact information
Practice address
201 LAKESIDE PARK, STE A, SOUTHAMPTON, PA 18966-4049
(215) 322-1058
(215) 322-1059
Mailing address
201 LAKESIDE PARK, STE A, SOUTHAMPTON, PA 18966-4049
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/16/2008
Last updated
06/16/2008
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