MEDICARE: DR. DANIEL 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	213E00000X	Podiatrist	N004378	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1487963880	OTHER	NY	ORGANIZATION-DMERC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1003082884	OTHER	NY	DMERC NPI
4	P49711	OTHER	NY	PTAN

General Provider Information

NPI Number	:	1598766206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL 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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	02/28/2022

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