MEDICARE: JONATHAN DAVID, MD, PC

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
1	207RG0100X	Gastroenterology Physician	178695	NY

General Provider Information

NPI Number	:	1336144104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN DAVID, MD, PC

Provider Business Mailing Address
First Line	:	136 SAGAMORE RD
Second Line	:
City	:	TUCKAHOE
State	:	NY
Zip	:	10707-4009
Country	:	US
Telephone Number	:	914-337-6400
Fax Number	:	914-337-8109

Provider Business Practice Location Address
First Line	:	136 SAGAMORE RD
Second Line	:
City	:	TUCKAHOE
State	:	NY
Zip	:	10707-4009
Country	:	US
Telephone Number	:	914-337-6400
Fax Number	:	914-337-8109

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JONATHAN DAVID
Credential	:	MD
Telephone Number	:	914-337-6400

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/28/2010

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