MEDICARE: MS. DEBORAH DAVIDSON LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	111398-01	NY

General Provider Information

NPI Number	:	1063097459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH DAVIDSON LMSW

Provider Business Mailing Address
First Line	:	465 E LINCOLN AVE APT 305
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-3536
Country	:	US
Telephone Number	:	917-435-9184
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 E LINCOLN AVE APT 305
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-3536
Country	:	US
Telephone Number	:	917-435-9184
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	03/16/2021

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