Provider Demographics
NPI:1720286123
Name:DAVIDMAN, JOHN J BENJAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J BENJAMIN
Last Name:DAVIDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:560 BROADWAY
Mailing Address - Street 2:SUITE 510
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012
Mailing Address - Country:US
Mailing Address - Phone:212-219-0046
Mailing Address - Fax:212-219-0047
Practice Address - Street 1:560 BROADWAY
Practice Address - Street 2:SUITE 510
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3938
Practice Address - Country:US
Practice Address - Phone:212-219-0046
Practice Address - Fax:212-219-0047
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2246652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry