Healthcare Provider Details

I. General information

NPI: 1376954560
Provider Name (Legal Business Name): JOSHUA MICHAEL DAVIDSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2014
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WATERS PL STE M101
BRONX NY
10461-2729
US

IV. Provider business mailing address

2649 STRANG BLVD STE 304
YORKTOWN HEIGHTS NY
10598-2938
US

V. Phone/Fax

Practice location:
  • Phone: 718-892-1200
  • Fax:
Mailing address:
  • Phone: 646-745-6369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number303030
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: