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General NPI Number Information
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NPI Number | 1104084862
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Entity Type | Individual
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Provider Name | DAVID JOHN DAVIS II D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 255 E HOUSTON ST
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City | NEW YORK
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State | NY
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Zip | 10002-1013
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Country | US
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Telephone | 212-477-1120
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Fax | 212-477-8957
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Provider Business Mailing Address
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Address Line | 60 MADISON AVE FL 5
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City | NEW YORK
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State | NY
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Zip | 10010-1600
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Country | US
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Telephone | 212-545-2400
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Fax | 212-463-8411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | OS 2964-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 2964-L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 256174
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License Number State | NY
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