MEDICARE: AJARAE 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
1	1041C0700X	Clinical Social Worker	44SC06584300	NJ

General Provider Information

NPI Number	:	1851074793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJARAE DAVIS

Provider Business Mailing Address
First Line	:	351 N NEW HAMPSHIRE AVE APT 901
Second Line	:
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-2978
Country	:	US
Telephone Number	:	609-457-1980
Fax Number	:

Provider Business Practice Location Address
First Line	:	6821 BLACK HORSE PIKE
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-4101
Country	:	US
Telephone Number	:	609-457-1980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	12/01/2025

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