Healthcare Provider Details

I. General information

NPI: 1891431987
Provider Name (Legal Business Name): DESAVIA EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SEXTON CT
HUNTINGTON NY
11743-4842
US

IV. Provider business mailing address

7 SEXTON CT
HUNTINGTON NY
11743-4842
US

V. Phone/Fax

Practice location:
  • Phone: 516-462-0221
  • Fax:
Mailing address:
  • Phone: 516-462-0221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number127203
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: