Healthcare Provider Details

I. General information

NPI: 1811731060
Provider Name (Legal Business Name): DAVID BEYDA MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2024
Last Update Date: 06/22/2024
Certification Date: 06/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14123 59TH AVE
FLUSHING NY
11355-5304
US

IV. Provider business mailing address

14123 59TH AVE
FLUSHING NY
11355-5304
US

V. Phone/Fax

Practice location:
  • Phone: 646-322-2410
  • Fax: 800-557-3140
Mailing address:
  • Phone: 646-322-2410
  • Fax: 800-557-3140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID J BEYDA
Title or Position: PHYSICIAN - OWNER
Credential: MD
Phone: 646-322-2410