Provider Demographics
NPI:1174683213
Name:GODFRIED, DAVID HARRIS (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HARRIS
Last Name:GODFRIED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 E 90TH ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7916
Mailing Address - Country:US
Mailing Address - Phone:516-640-6609
Mailing Address - Fax:646-537-9249
Practice Address - Street 1:5 E 98TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-9060
Practice Address - Fax:646-537-9249
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226281207X00000X, 207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty