David Champlin

Individual provider Active NPI Physician Assistant · Maspeth, NY

NPI 1861968034 · NPPES record last updated Oct 15, 2018

Key facts

NPI
1861968034
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
022770 (NY)
Practice address
7301 Grand Ave
Maspeth, NY 11378-1523
Phone
(718) 457-5900
NPI assigned
Oct 15, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
022770NYMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022770 NY Yes

Addresses

Primary practice location

7301 Grand Ave
Maspeth, NY 11378-1523

Mailing address

5902 60TH St
Maspeth, NY 11378-3234

Other providers in Maspeth, NY

All providers in Maspeth, NY · Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.