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General NPI Number Information
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NPI Number | 1326241670
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Entity Type | Individual
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Provider Name | ROZALINA DAVIDOVICH PSY.D
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 900 WALT WHITMAN RD STE 302
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City | MELVILLE
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State | NY
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Zip | 11747-2215
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Country | US
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Telephone | 917-770-4909
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Fax | 631-504-0277
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Provider Business Mailing Address
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Address Line | 102 PEMBROKE AVE
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City | MELVILLE
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State | NY
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Zip | 11747-4309
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Country | US
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Telephone | 917-770-4909
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Fax | 631-504-0277
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 017159
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License Number State | NY
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