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General NPI Number Information
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NPI Number | 1619405024
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Entity Type | Organization
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Legal Business Name | DAVID D. MANEVITZ, DO, PC
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1975 HEMPSTEAD TPKE STE 405
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City | EAST MEADOW
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State | NY
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Zip | 11554-1703
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Country | US
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Telephone | 516-307-9088
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Fax | 516-307-9089
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Provider Business Mailing Address
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Address Line | 1975 HEMPSTEAD TPKE STE 405
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City | EAST MEADOW
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State | NY
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Zip | 11554-1703
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Country | US
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Telephone | 516-307-9088
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Fax | 516-307-9089
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Authorized Official
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Title or Position | OWNER
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Name | DAVID D. MANEVITZ
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Credential | DO
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Telephone | 516-307-9088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 228763
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License Number State | NY
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