Provider Demographics
NPI:1104084862
Name:DAVIS, DAVID JOHN II (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:DAVIS
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:60 MADISON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:212-545-2400
Mailing Address - Fax:212-463-8411
Practice Address - Street 1:255 E HOUSTON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-1013
Practice Address - Country:US
Practice Address - Phone:212-477-1120
Practice Address - Fax:212-477-8957
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2024-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS 2964-L207K00000X, 207Q00000X
NY256174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology