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NPI Code Detail

MEDICARE: ROBERT DAVIS

MEDICARE: ROBERT DAVIS
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
1225X00000XOccupational Therapist009667-1NY

General Provider Information

NPI Number : 1629276654
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT DAVIS
Provider Business Mailing Address
First Line : 2614 MILL AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-6423
Country : US
Telephone Number : 718-434-4600
Fax Number : 718-434-6261
Provider Business Practice Location Address
First Line : 1221 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-4803
Country : US
Telephone Number : 718-434-4600
Fax Number : 718-434-6261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2007
Last Update Date : 07/11/2007

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