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NPI Code Detail

MEDICARE: DR. DAVID JOHN DAVIS II D.O.

MEDICARE: DR. DAVID JOHN DAVIS II D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology PhysicianOS 2964-LPA
2207Q00000XFamily Medicine PhysicianOS 2964-LPA
3207Q00000XFamily Medicine Physician256174NY

General Provider Information

NPI Number : 1104084862
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID JOHN DAVIS II D.O.
Provider Business Mailing Address
First Line : 60 MADISON AVE FL 5
Second Line :
City : NEW YORK
State : NY
Zip : 10010-1600
Country : US
Telephone Number : 212-545-2400
Fax Number : 212-463-8411
Provider Business Practice Location Address
First Line : 255 E HOUSTON ST
Second Line :
City : NEW YORK
State : NY
Zip : 10002-1013
Country : US
Telephone Number : 212-477-1120
Fax Number : 212-477-8957
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2008
Last Update Date : 10/15/2024

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Directions to “ DR. DAVID JOHN DAVIS II D.O.” Practice Location

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