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General NPI Number Information
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NPI Number | 1265797047
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Entity Type | Individual
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Provider Name | MS. PAULA A DAVIS
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Gender | Female
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5902 14TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11219-5066
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Country | US
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Telephone | 718-686-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 18 PIERPONT PL
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5945
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Country | US
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Telephone | 347-466-5259
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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