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NPI Code Detail

MEDICARE: DAVIS Q. PHAM PMHNP

MEDICARE: DAVIS Q. PHAM PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner406796NY

General Provider Information

NPI Number : 1437012481
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVIS Q. PHAM PMHNP
Provider Business Mailing Address
First Line : 400 SUNRISE HWY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2508
Country : US
Telephone Number : 631-264-4000
Fax Number : 631-608-5261
Provider Business Practice Location Address
First Line : 400 SUNRISE HWY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2508
Country : US
Telephone Number : 631-264-4000
Fax Number : 631-608-5261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2025
Last Update Date : 12/09/2025

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