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General NPI Number Information
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NPI Number | 1215933072
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Entity Type | Individual
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Provider Name | ALLAN E DAVIS O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 12/02/2018
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Provider Practice Location Address
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Address Line | 1111 FRANKLIN AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-1617
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Country | US
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Telephone | 516-248-7528
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Fax |
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Provider Business Mailing Address
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Address Line | 932 HILLSIDE AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2522
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Country | US
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Telephone | 516-437-2120
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV005468
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License Number State | NY
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