Healthcare Provider Details

I. General information

NPI: 1528880945
Provider Name (Legal Business Name): DAVID BEYDA MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6118 190TH ST STE 215
FRESH MEADOWS NY
11365-2724
US

IV. Provider business mailing address

6118 190TH ST STE 215
FRESH MEADOWS NY
11365-2724
US

V. Phone/Fax

Practice location:
  • Phone: 718-461-6161
  • Fax: 516-517-9515
Mailing address:
  • Phone: 718-461-6161
  • Fax: 516-517-9515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID BEYDA
Title or Position: PHYSICIAN / OWNER
Credential: MD
Phone: 516-650-4604