Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 195763 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | NYS195763 | NY |
NPI | 1396727665 |
---|---|
Provider Name | Dr. Mark Davis-Lorton |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Sleepy Hollow, NY 10591-4073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 02/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01592112 | (05) | NY |
G13346 | (02) | NY |