Provider Demographics
NPI:1912749474
Name:DAVIS, ATHENA EVDOXIA
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:EVDOXIA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 CONCORD AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1397
Mailing Address - Country:US
Mailing Address - Phone:201-220-5718
Mailing Address - Fax:
Practice Address - Street 1:271 CONCORD AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1397
Practice Address - Country:US
Practice Address - Phone:201-220-5718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula