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NPI Code Detail

MEDICARE: DR. DAVID HENRY JOHN M.D.

MEDICARE: DR. DAVID HENRY JOHN M.D.
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
1207Q00000XFamily Medicine Physician188736NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194741819
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID HENRY JOHN M.D.
Provider Business Mailing Address
First Line : 1413 E 104TH ST
Second Line : APT 1
City : BROOKLYN
State : NY
Zip : 11236-4515
Country : US
Telephone Number : 718-763-0237
Fax Number :
Provider Business Practice Location Address
First Line : 1167 NOSTRAND AVE
Second Line : BROOKLYN
City : BROOKLYN
State : NY
Zip : 11225-5417
Country : US
Telephone Number : 718-778-0198
Fax Number : 718-221-8169
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 12/29/2011

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