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NPI Code Detail

MEDICARE: MATTHEW DAVIS

MEDICARE:   MATTHEW  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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1841099926
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW DAVIS
Provider Business Mailing Address
First Line : 24 JASKOT LN
Second Line :
City : CLIFTON
State : NJ
Zip : 07012-1105
Country : US
Telephone Number : 973-508-3746
Fax Number :
Provider Business Practice Location Address
First Line : 24 JASKOT LN
Second Line :
City : CLIFTON
State : NJ
Zip : 07012-1105
Country : US
Telephone Number : 973-508-3746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2025
Last Update Date : 03/11/2025

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Directions to “ MATTHEW DAVIS ” Practice Location

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