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General NPI Number Information
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NPI Number | 1639975907
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Entity Type | Individual
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Provider Name | MR. JOSE L DAVIS
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Gender | Male
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 539 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-3264
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Country | US
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Telephone | 973-246-4445
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Fax |
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Provider Business Mailing Address
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Address Line | 224 W 35TH ST STE 500
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City | NEW YORK
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State | NY
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Zip | 10001-2538
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Country | US
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Telephone | 718-266-0900
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Fax | 718-266-1426
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 582379
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AG02250044
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License Number State | NJ
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