Dynof, David Randall
Dynof, David Randall is an sole proprietor health care provider with primary practice located at 2 Coraci Blvd Ste 1, Shirley NY 11967-4833. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Dynof, David Randall can be contacted via phone (212) 682-2750.Contact Information
Primary practice address
2 Coraci Blvd Ste 1
Shirley NY 11967-4833
Phone: (212) 682-2750
Fax: (212) 682-6588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 225074-1 | New York |
Profile Details
| NPI number | 1912908989 |
|---|---|
| LBN Legal business name | Dynof, David Randall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Feb 21st, 2018 - about 7 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 | 1912908989 | NPPES |
| New York | MEDICAID | 02613927 |
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