Provider Demographics
NPI:1548848138
Name:DAVYDOVSKAYA, ALBINA S
Entity type:Individual
Prefix:
First Name:ALBINA
Middle Name:S
Last Name:DAVYDOVSKAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33075 WAGON WHEEL DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2346
Mailing Address - Country:US
Mailing Address - Phone:440-539-1056
Mailing Address - Fax:
Practice Address - Street 1:7235 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:REMINDERVILLE
Practice Address - State:OH
Practice Address - Zip Code:44202-8758
Practice Address - Country:US
Practice Address - Phone:330-562-7084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist