Healthcare Provider Details

I. General information

NPI: 1033947809
Provider Name (Legal Business Name): DAVIKA JAMES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 DEERFIELD RD
MONROE NY
10950-5116
US

IV. Provider business mailing address

1201 DEERFIELD RD
MONROE NY
10950-5116
US

V. Phone/Fax

Practice location:
  • Phone: 917-535-1132
  • Fax:
Mailing address:
  • Phone: 917-535-1132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number543639
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: