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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215923990 NPPES
New York MEDICAID 01979708

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