Davidenko, Jorge M
Davidenko, Jorge M is an individual health care provider with primary practice located at 134 Homer Ave , Cortland NY 13045-1206. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Davidenko, Jorge M can be contacted via phone (607) 756-3561.Contact Information
Primary practice address
134 Homer Ave
Cortland NY 13045-1206
Phone: (607) 756-3561
Fax: (607) 428-5142
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | 196572 | New York |
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 196572 | New York |
Profile Details
NPI number | 1215923990 |
---|---|
LBN Legal business name | Davidenko, Jorge M |
Credentials | MD FACC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 27th, 2005 |
Last updated | Mar 8th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1215923990 | NPPES |
New York | MEDICAID | 01979708 |
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