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General NPI Number Information
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NPI Number | 1336693985
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Entity Type | Organization
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Legal Business Name | DANIEL DAVIES
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 252 E MAIN ST
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City | EAST ISLIP
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State | NY
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Zip | 11730-2722
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Country | US
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Telephone | 631-581-8828
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Fax | 631-581-0545
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Provider Business Mailing Address
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Address Line | 252 E MAIN ST
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City | EAST ISLIP
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State | NY
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Zip | 11730-2722
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Country | US
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Telephone | 631-581-8828
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Fax | 631-581-0545
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Authorized Official
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Title or Position | OWNER/PODIATRIST
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Name | DANIEL DAVIES
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Credential | DPM
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Telephone | 631-581-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | N004378
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License Number State | NY
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