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General NPI Number Information
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NPI Number | 1336144104
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Entity Type | Organization
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Legal Business Name | JONATHAN DAVID, MD, PC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 136 SAGAMORE RD
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City | TUCKAHOE
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State | NY
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Zip | 10707-4009
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Country | US
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Telephone | 914-337-6400
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Fax | 914-337-8109
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Provider Business Mailing Address
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Address Line | 136 SAGAMORE RD
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City | TUCKAHOE
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State | NY
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Zip | 10707-4009
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Country | US
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Telephone | 914-337-6400
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Fax | 914-337-8109
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONATHAN DAVID
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Credential | MD
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Telephone | 914-337-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 178695
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License Number State | NY
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