MEDICARE: THOMAS DAVIES DPM

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	261QP1100X	Podiatric Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1528227907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS DAVIES DPM

Provider Business Mailing Address
First Line	:	252 E MAIN ST
Second Line	:
City	:	EAST ISLIP
State	:	NY
Zip	:	11730-2722
Country	:	US
Telephone Number	:	631-581-8828
Fax Number	:	631-581-0545

Provider Business Practice Location Address
First Line	:	252 E MAIN ST
Second Line	:
City	:	EAST ISLIP
State	:	NY
Zip	:	11730-2722
Country	:	US
Telephone Number	:	631-581-8828
Fax Number	:	631-581-0545

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ELAINE CONTONA
Credential	:
Telephone Number	:	631-581-8828

Provider Enumeration Date	:	06/02/2008
Last Update Date	:	08/28/2008

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Directions to “THOMAS DAVIES DPM ” Practice Location

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